Provider Demographics
NPI:1780142232
Name:KIMBALL, KYLEE (DPT)
Entity type:Individual
Prefix:DR
First Name:KYLEE
Middle Name:
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KYLEE
Other - Middle Name:
Other - Last Name:HUTCHINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:432 W ROCKRIMMON BLVD UNIT D
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1735
Mailing Address - Country:US
Mailing Address - Phone:719-694-4054
Mailing Address - Fax:
Practice Address - Street 1:7622 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4710
Practice Address - Country:US
Practice Address - Phone:719-495-3133
Practice Address - Fax:719-471-4415
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016481225100000X, 225100000X
CA296260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist