Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 11782 | NC |
N | 2251P0200X | Physical Therapist - Pediatrics | 5871 | SC |
NPI | 1073751210 |
---|---|
Provider Name | Kimberly Shoemaker Jones |
First Address | Clinton, NC 28329-0362 |
Second Address | Clinton, NC 28328-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2009 |
Last Update Date | 06/01/2015 |