Organization
TRACI A. KIMBALL MD PC
Active
Other names
The Wish Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI A. KIMBALL (OWNER)
(303) 940-1611
Entity
Organization
Contact information
Practice address
10050 RALSTON RD UNIT 3, ARVADA, CO 80004-4974
(303) 940-1611
(303) 432-2296
Mailing address
10050 RALSTON RD UNIT 3, ARVADA, CO 80004-4974
(303) 940-1611
(303) 432-2296
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
163WC0400X
Case Management Registered Nurse
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
—
163WW0000X
Wound Care Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
171400000X
Health & Wellness Coach
—
—
1744R1102X
Research Study Specialist
—
—
202D00000X
Integrative Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
224Y00000X
Clinical Exercise Physiologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000223352
—
CO
Enumeration date
10/18/2023
Last updated
03/16/2026
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