Individual
KRISTINE JEAN KIMMLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6538
(414) 246-6505
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-013381
IL
225100000X
Physical Therapist
Primary
10042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100289077
—
WI
Enumeration date
05/03/2007
Last updated
09/24/2024
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