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NPI Code Detail

MEDICARE: KIMBERLY J. LYNN PT

MEDICARE: KIMBERLY J. LYNN 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 Therapist7794MN

General Provider Information

NPI Number : 1730211848
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY J. LYNN PT
Provider Business Mailing Address
First Line : 1600 HIGHWAY 100 S
Second Line :
City : SAINT LOUIS PARK
State : MN
Zip : 55416-1506
Country : US
Telephone Number : 763-531-5039
Fax Number : 736-591-5004
Provider Business Practice Location Address
First Line : 9751 REGENT AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-1402
Country : US
Telephone Number : 763-315-5340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 12/04/2025

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