Provider Demographics
NPI:1922030717
Name:FOX, KIMBERLY L (PT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:FOX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 E. MAIN ST.
Mailing Address - Street 2:SUITE B102
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:615-826-7113
Mailing Address - Fax:615-826-7139
Practice Address - Street 1:639 E MAIN ST
Practice Address - Street 2:SUITE B102
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2646
Practice Address - Country:US
Practice Address - Phone:615-826-7113
Practice Address - Fax:615-826-7139
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000001507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist