Individual
KIMBERLY K NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
9817 E US HIGHWAY 36, AVON, IN 46123-7954
(317) 860-7677
(317) 860-7668
Mailing address
33900 HARPER AVE, SUITE 104, CLINTON TOWNSHIP, MI 48035-4258
(586) 416-9100
(586) 416-9103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05006846A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111999
ANTHEM ID
IN
05
—
200274820
—
IN
Enumeration date
03/02/2006
Last updated
11/20/2024
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