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General NPI Number Information
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NPI Number | 1689175747
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Entity Type | Individual
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Provider Name | KIMBERLY HUBBARD PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 2225 W SOUTHERN AVE
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City | MESA
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State | AZ
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Zip | 85202-4716
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Country | US
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Telephone | 480-412-4101
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Fax | 480-412-8729
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Provider Business Mailing Address
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Address Line | 1009 W VIA DE PALMAS
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-7448
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Country | US
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Telephone | 480-235-1313
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 9967
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License Number State | AZ
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