Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 002556 | KY |
NPI | 1073081469 |
---|---|
Provider Name | Kimberly Ann Yungbluth |
First Address | Cincinnati, OH 45229-2833 |
Second Address | Cincinnati, OH 45229-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 05/11/2018 |