Individual
KIMBERLY FREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 280-7036
Mailing address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 256-1901
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2121-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518398627
—
WI
Enumeration date
11/29/2013
Last updated
06/23/2016
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