Provider Demographics
NPI:1982895876
Name:PEER, KIMBERLY SUE (EDD, ATC, LAT)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:SUE
Last Name:PEER
Suffix:
Gender:F
Credentials:EDD, ATC, LAT
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 5190 - ROOM 161D MACC ANNEX
Mailing Address - Street 2:KENT STATE UNIVERSITY
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44242-0001
Mailing Address - Country:US
Mailing Address - Phone:330-672-0231
Mailing Address - Fax:330-672-4106
Practice Address - Street 1:KENT STATE UNIVERSITY
Practice Address - Street 2:161D MACC ANNEX
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44242-0001
Practice Address - Country:US
Practice Address - Phone:330-672-0231
Practice Address - Fax:330-672-4106
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT-1222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer