MEDICARE: KIMBERLY R. REID DPT

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	PT33241	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT33241	OTHER	CA	PT LICENSE

General Provider Information

NPI Number	:	1922170935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY R. REID DPT

Provider Business Mailing Address
First Line	:	3642 ROSECREST CIR
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9522
Country	:	US
Telephone Number	:	949-637-2980
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 K ST
Second Line	:	SUITE 170
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-5124
Country	:	US
Telephone Number	:	916-448-4884
Fax Number	:	916-452-8821

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/11/2016

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Directions to “ KIMBERLY R. REID DPT” Practice Location

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