Provider Demographics
NPI:1598455024
Name:KIMBROUGH, KATHERINE (DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:KIMBROUGH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:CORONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4 OFFICE PARK CIR STE 217
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2674
Mailing Address - Country:US
Mailing Address - Phone:205-263-2770
Mailing Address - Fax:205-263-0994
Practice Address - Street 1:183 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1496
Practice Address - Country:US
Practice Address - Phone:205-655-1009
Practice Address - Fax:205-655-1264
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11314225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist