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NPI Code Detail

MEDICARE: KIMBERLY COLEY P.T.A.

MEDICARE: KIMBERLY COLEY P.T.A.
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
1225200000XPhysical Therapy AssistantPTA3874AL

General Provider Information

NPI Number : 1871965434
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY COLEY P.T.A.
Provider Business Mailing Address
First Line : PO BOX 7315
Second Line :
City : SPANISH FORT
State : AL
Zip : 36577-7315
Country : US
Telephone Number : 251-366-9722
Fax Number :
Provider Business Practice Location Address
First Line : 500 SPANISH FORT BLVD
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5018
Country : US
Telephone Number : 251-626-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2015
Last Update Date : 01/14/2016

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Directions to “ KIMBERLY COLEY P.T.A.” Practice Location

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