Provider Demographics
NPI:1275574881
Name:PLAYER, KIMBERLY SHAWN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SHAWN
Last Name:PLAYER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 OAK SIDE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7630
Mailing Address - Country:US
Mailing Address - Phone:334-271-6359
Mailing Address - Fax:
Practice Address - Street 1:1125 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2313
Practice Address - Country:US
Practice Address - Phone:334-284-8490
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer