Individual
KIMBERLEY A MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 KINGSBURY ST, KEENE, NH 03431-3825
(603) 352-0165
Mailing address
206 MAIN ST # 4729, NORTHFIELD, MA 01360-1050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2252
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08Y005291NH03
ANTHEM
NH
01
—
373100
MVP
NH
Enumeration date
02/28/2007
Last updated
07/08/2007
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