Provider Demographics
NPI:1841256146
Name:HOOBLER, KIMBERLY D (DPT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:HOOBLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 SW GAGE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1998
Mailing Address - Country:US
Mailing Address - Phone:785-207-5440
Mailing Address - Fax:
Practice Address - Street 1:1047 SW GAGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1998
Practice Address - Country:US
Practice Address - Phone:785-207-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153512251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS927673OtherFIRST GUARD
KSP00238947OtherRAILROAD MEDICARE
KS140916OtherBLUE CROSS - BLUE SHIELD
KS100291060BMedicaid
KS10427OtherPREFERRED HEALTH SYSTEMS
KS140916Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #