Provider Demographics
NPI:1598270910
Name:LINTON, KIMBERLY A (MSPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:LINTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:O.T. WORKS, INC
Mailing Address - Street 2:1309 E MARKET STREET; SUITE 5
Mailing Address - City:NAPPANEE
Mailing Address - State:IN
Mailing Address - Zip Code:46550-1115
Mailing Address - Country:US
Mailing Address - Phone:574-773-7733
Mailing Address - Fax:574-773-7133
Practice Address - Street 1:1309 E MARKET STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-1115
Practice Address - Country:US
Practice Address - Phone:574-773-7733
Practice Address - Fax:574-773-7133
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003076A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty