Provider Demographics
NPI:1467736579
Name:PAUL-MARINO, KIM CHRISTIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:CHRISTIE
Last Name:PAUL-MARINO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:171 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-4065
Mailing Address - Country:US
Mailing Address - Phone:413-536-7824
Mailing Address - Fax:413-534-0084
Practice Address - Street 1:171 PINE ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-4065
Practice Address - Country:US
Practice Address - Phone:413-536-7824
Practice Address - Fax:413-534-0084
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic