MEDICARE: FRANCES ANNE KIMBROUGH 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
1	225100000X	Physical Therapist	100172	MO

General Provider Information

NPI Number	:	1801821673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES ANNE KIMBROUGH PT

Provider Business Mailing Address
First Line	:	PO BOX 1100
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-1100
Country	:	US
Telephone Number	:	417-257-5959
Fax Number	:	417-257-5814

Provider Business Practice Location Address
First Line	:	37 MEDICAL DRIVE
Second Line	:
City	:	GAINESVILLE
State	:	MO
Zip	:	65655
Country	:	US
Telephone Number	:	417-679-4613
Fax Number	:	417-679-2211

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	11/25/2015

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