Provider Demographics
NPI:1205866209
Name:HOPKINS, KIM L (PT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:L
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:L
Other - Last Name:DE VERSTERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, CLT
Mailing Address - Street 1:34 US ROUTE 1 BOX 901
Mailing Address - Street 2:
Mailing Address - City:BUCKSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04416-0901
Mailing Address - Country:US
Mailing Address - Phone:207-469-0786
Mailing Address - Fax:207-469-9975
Practice Address - Street 1:34 US ROUTE 1 BOX 901
Practice Address - Street 2:
Practice Address - City:BUCKSPORT
Practice Address - State:ME
Practice Address - Zip Code:04416-0901
Practice Address - Country:US
Practice Address - Phone:207-469-0786
Practice Address - Fax:207-469-9975
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist