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NPI Code Detail

MEDICARE: MR. KIMBERLY A DUCKWORTH PT

MEDICARE: MR. KIMBERLY A DUCKWORTH PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT007270GA

General Provider Information

NPI Number : 1073957031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KIMBERLY A DUCKWORTH PT
Provider Business Mailing Address
First Line : 7860 FAWNDALE WAY
Second Line :
City : ATLANTA
State : GA
Zip : 30350-1061
Country : US
Telephone Number : 770-352-9670
Fax Number :
Provider Business Practice Location Address
First Line : 5671 PEACHTREE DUNWOODY RD NE STE 520
Second Line :
City : ATLANTA
State : GA
Zip : 30342-5005
Country : US
Telephone Number : 678-843-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2013
Last Update Date : 04/22/2013

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Directions to “ MR. KIMBERLY A DUCKWORTH PT” Practice Location

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