Provider Demographics
NPI:1184231862
Name:ORTMAN, KIM M
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:M
Last Name:ORTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5745 CURNIE DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9068
Mailing Address - Country:US
Mailing Address - Phone:513-518-2659
Mailing Address - Fax:
Practice Address - Street 1:5745 CURNIE DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9068
Practice Address - Country:US
Practice Address - Phone:513-518-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker