Provider Demographics
NPI:1720592066
Name:KIRK, KIMBERLY L (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:KIRK
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S 44TH ST W APT 5109
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3956
Mailing Address - Country:US
Mailing Address - Phone:719-684-5809
Mailing Address - Fax:
Practice Address - Street 1:2702 8TH AVE N
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1107
Practice Address - Country:US
Practice Address - Phone:406-238-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-23
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer