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Individual

AMY LYNN KIMBALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, ATC

Contact information

Practice address
1717 BOYSON RD, HIAWATHA, IA 52233-2313
(319) 200-2004
(319) 200-2009
Mailing address
1717 BOYSON RD, HIAWATHA, IA 52233-2313
(319) 200-2004
(319) 200-2009

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02905
IA
2251S0007X
Sports Physical Therapist
02905
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02905
IOWA PT LICENSE
IA
Enumeration date
01/26/2006
Last updated
09/16/2020
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