Organization
TRACI A. KIMBALL MD PC
Active
Other names
The WISH Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI A. KIMBALL MD (OWNER)
(720) 557-6510
Entity
Organization
Contact information
Practice address
10050 RALSTON RD UNIT 3, ARVADA, CO 80004-4974
(720) 577-4584
(720) 577-4587
Mailing address
10050 RALSTON RD UNIT 3, ARVADA, CO 80004-4974
(720) 577-4584
(720) 577-4587
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
—
—
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
202D00000X
Integrative Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR1100X
Research Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41180259
—
CO
Enumeration date
09/05/2014
Last updated
04/07/2025
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