MEDICARE: MRS. KIMBERLY SUE DEHN OTR/L

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	2251X0800X	Orthopedic Physical Therapist	2055026	WI

General Provider Information

NPI Number	:	1942273024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY SUE DEHN OTR/L

Provider Business Mailing Address
First Line	:	4000 JACOBSGAARD LN
Second Line	:
City	:	CAMINO
State	:	CA
Zip	:	95709-9107
Country	:	US
Telephone Number	:	530-295-3948
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 JACOBSGAARD LN
Second Line	:
City	:	CAMINO
State	:	CA
Zip	:	95709-9107
Country	:	US
Telephone Number	:	530-295-3948
Fax Number	:

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	08/11/2016

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