MEDICARE: SCOTT DAVID KIMBLE DC

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
1	111N00000X	Chiropractor	DC4467	TX

General Provider Information

NPI Number	:	1609909324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT DAVID KIMBLE DC

Provider Business Mailing Address
First Line	:	PO BOX 219
Second Line	:	413 E CALVERT
City	:	KARNES CITY
State	:	TX
Zip	:	78118
Country	:	US
Telephone Number	:	830-780-2213
Fax Number	:	830-780-2558

Provider Business Practice Location Address
First Line	:	413 E CALVERT
Second Line	:
City	:	KARNES CITY
State	:	TX
Zip	:	78118
Country	:	US
Telephone Number	:	830-780-2213
Fax Number	:	830-780-2558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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Directions to “ SCOTT DAVID KIMBLE DC” Practice Location

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