Provider Demographics
NPI:1760410922
Name:LORD, KIMBERLY LYNN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LYNN
Last Name:LORD
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1710 BELVUE DR
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2509
Mailing Address - Country:US
Mailing Address - Phone:410-893-0696
Mailing Address - Fax:410-893-0696
Practice Address - Street 1:2 COLGATE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2624
Practice Address - Country:US
Practice Address - Phone:410-879-7769
Practice Address - Fax:410-879-8545
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD19527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist