Provider Demographics
NPI:1972766400
Name:MOSER, KIMBERLY M (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:M
Last Name:MOSER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-8171
Mailing Address - Country:US
Mailing Address - Phone:610-689-8133
Mailing Address - Fax:
Practice Address - Street 1:1 S HOME AVE
Practice Address - Street 2:LUTHERAN HOME
Practice Address - City:TOPTON
Practice Address - State:PA
Practice Address - Zip Code:19562-1317
Practice Address - Country:US
Practice Address - Phone:610-682-1478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013087L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist