Provider Demographics
NPI:1598079550
Name:ADAMSON, KIMBERLY A (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 E OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3035
Mailing Address - Country:US
Mailing Address - Phone:702-528-9058
Mailing Address - Fax:480-361-8216
Practice Address - Street 1:4730 E LONE MOUNTAIN RD STE 114
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-5539
Practice Address - Country:US
Practice Address - Phone:480-272-7140
Practice Address - Fax:480-361-8216
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist