Provider Demographics
NPI:1922231000
Name:KIMBERLY J NUNN MHS PT LLC
Entity Type:Organization
Organization Name:KIMBERLY J NUNN MHS PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, PT
Authorized Official - Phone:216-373-6767
Mailing Address - Street 1:4991 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1005
Mailing Address - Country:US
Mailing Address - Phone:216-373-6767
Mailing Address - Fax:
Practice Address - Street 1:4991 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1005
Practice Address - Country:US
Practice Address - Phone:216-373-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty