Provider Demographics
NPI:1083812713
Name:MORIN, KIMBERLY E (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:E
Last Name:MORIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:E
Other - Last Name:DESKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25229 S SUN LAKES BLVD
Mailing Address - Street 2:STE 119
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-6453
Mailing Address - Country:US
Mailing Address - Phone:480-883-6734
Mailing Address - Fax:480-895-8143
Practice Address - Street 1:1076 W CHANDLER BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5225
Practice Address - Country:US
Practice Address - Phone:480-821-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8415225100000X
CO10129225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist