Provider Demographics
NPI:1346345022
Name:KIMBERLIN, ROBERT K
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:KIMBERLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 N FM 1417
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-6634
Mailing Address - Country:US
Mailing Address - Phone:903-868-3808
Mailing Address - Fax:903-868-1432
Practice Address - Street 1:3409 N FM 1417
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-6634
Practice Address - Country:US
Practice Address - Phone:903-868-3808
Practice Address - Fax:903-868-1432
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10402111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition