Provider Demographics
NPI:1356778724
Name:WINTERSTEIN, KIM (PT)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:WINTERSTEIN
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 1:7277 NC HIGHWAY 42
Mailing Address - Street 2:SUITE 208
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-7527
Mailing Address - Country:US
Mailing Address - Phone:919-773-4086
Mailing Address - Fax:919-773-4087
Practice Address - Street 1:7277 NC HIGHWAY 42
Practice Address - Street 2:SUITE 208
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-7527
Practice Address - Country:US
Practice Address - Phone:919-773-4086
Practice Address - Fax:919-773-4087
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP9210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist