Provider Demographics
NPI:1265949010
Name:PEARCE, KIMBERLY (DPT,PT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:DPT,PT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:35 MILES ST
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4047
Mailing Address - Country:US
Mailing Address - Phone:207-563-1234
Mailing Address - Fax:
Practice Address - Street 1:175 BLUEBERRY LN
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2918
Practice Address - Country:US
Practice Address - Phone:603-524-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61208069225100000X
NH5644225100000X
ME6072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist