Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 100 | GA |
Y | 222Z00000X | Podiatrist | 100 | GA |
N | 224P00000X | Prosthetist | 100 | GA |
NPI | 1235437187 |
---|---|
Provider Name | Miss Kimberly Kathleen Hill |
First Address | Sugar Hill, GA 30518-7613 |
Second Address | Sugar Hill, GA 30518-7613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2011 |
Last Update Date | 02/03/2011 |