Individual
KIMBERLY LINEBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 MAJOR DR, MANNING, SC 29102-3213
(803) 435-4435
Mailing address
PO BOX 209, TURBEVILLE, SC 29162-0209
(843) 657-2290
(843) 659-3204
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
103300
SC
225100000X
Physical Therapist
—
SC
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
SC
235Z00000X
Speech-Language Pathologist
09143618
SC
235Z00000X
Speech-Language Pathologist
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86-3905666
—
SC
Enumeration date
01/14/2022
Last updated
02/10/2022
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