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NPI Code Detail

MEDICARE: KIMBERLY STREET P.T.

MEDICARE: KIMBERLY STREET P.T.
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 Therapist18544MD

General Provider Information

NPI Number : 1730383738
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY STREET P.T.
Provider Business Mailing Address
First Line : 3206 CURTIS DR
Second Line : APT 206
City : TEMPLE HILLS
State : MD
Zip : 20748-1246
Country : US
Telephone Number : 301-894-2580
Fax Number :
Provider Business Practice Location Address
First Line : 4409 E WEST HWY
Second Line :
City : RIVERDALE
State : MD
Zip : 20737-1058
Country : US
Telephone Number : 301-699-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY STREET P.T.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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