Provider Demographics
NPI:1881739787
Name:HILL, KIMBERLY EASTLAND (PT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:EASTLAND
Last Name:HILL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:ELAINE
Other - Last Name:EASTLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1090 N ELLINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-2227
Mailing Address - Country:US
Mailing Address - Phone:931-270-3676
Mailing Address - Fax:931-270-3828
Practice Address - Street 1:1090 N ELLINGTON PKWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2227
Practice Address - Country:US
Practice Address - Phone:931-270-3676
Practice Address - Fax:931-270-3828
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000004464225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPT0000004464OtherPT LICENSE