Provider Demographics
NPI:1881120970
Name:GEIGER, KIM LORENE (CMT)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:LORENE
Last Name:GEIGER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60747
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95860-0747
Mailing Address - Country:US
Mailing Address - Phone:209-366-3493
Mailing Address - Fax:
Practice Address - Street 1:2920 ARDEN WAY STE C
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1392
Practice Address - Country:US
Practice Address - Phone:209-366-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129750225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist