Provider Demographics
NPI:1760695662
Name:COTTLE, KIMBERLEY JOAN (RPH)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:JOAN
Last Name:COTTLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:132 MIDDLE WINCHENDON RD.
Mailing Address - City:RINDGE
Mailing Address - State:NH
Mailing Address - Zip Code:03461-0638
Mailing Address - Country:US
Mailing Address - Phone:603-899-6403
Mailing Address - Fax:
Practice Address - Street 1:752 ROUTE 202
Practice Address - Street 2:
Practice Address - City:RINDGE
Practice Address - State:NH
Practice Address - Zip Code:03461
Practice Address - Country:US
Practice Address - Phone:603-899-2115
Practice Address - Fax:603-899-2117
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3025183500000X
MA23050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist