Provider Demographics
NPI:1598158644
Name:THOMAS, KIMBERLY GRAZIANO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:GRAZIANO
Last Name:THOMAS
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 1:5848 OLD BETHLEHEM PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9341
Mailing Address - Country:US
Mailing Address - Phone:610-526-7111
Mailing Address - Fax:
Practice Address - Street 1:5848 OLD BETHLEHEM PIKE STE 102
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9341
Practice Address - Country:US
Practice Address - Phone:610-776-8334
Practice Address - Fax:610-776-3185
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist