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General NPI Number Information
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NPI Number | 1457659153
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Entity Type | Individual
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Provider Name | KIMBERLY BYERS LAVERY P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 2310 W I-20 SUITE 204
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City | ARLINGTON
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State | TX
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Zip | 76017-1677
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Country | US
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Telephone | 817-466-7276
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 ACORN DR
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City | EULESS
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State | TX
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Zip | 76039-2464
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Country | US
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Telephone | 817-354-7675
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1037018
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License Number State | TX
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