Provider Demographics
NPI:1841376209
Name:SMITH-ORICCHIO, KIMBERLY C (PT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:C
Last Name:SMITH-ORICCHIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:ORICCHIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6200
Mailing Address - Fax:520-784-6390
Practice Address - Street 1:12315 N VISTOSO PARK RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-5819
Practice Address - Country:US
Practice Address - Phone:520-544-9700
Practice Address - Fax:520-618-6060
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011903225100000X
AZLPT-31732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R88672Medicare UPIN