Provider Demographics
NPI:1649970179
Name:LAMZIK, KIMBERLY ALICE (PT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ALICE
Last Name:LAMZIK
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 1:65 N JOYCE ELLEN WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1203
Mailing Address - Country:US
Mailing Address - Phone:636-699-0982
Mailing Address - Fax:
Practice Address - Street 1:7068 S OUTER 364
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7757
Practice Address - Country:US
Practice Address - Phone:636-240-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO102125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist