Provider Demographics
NPI:1598281958
Name:WOLF-KING, KIMBERLY SARA (DPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SARA
Last Name:WOLF-KING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:SARA
Other - Last Name:WOLF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:400 CONCORD PLAZA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6991
Mailing Address - Country:US
Mailing Address - Phone:210-804-5416
Mailing Address - Fax:210-678-4142
Practice Address - Street 1:150 E SONTERRA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4184
Practice Address - Country:US
Practice Address - Phone:210-804-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32838225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist