Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA783 | AL |
NPI | 1013143981 |
---|---|
Provider Name | Mrs. Kimberly Kay Simpson |
First Address | Fyffe, AL 35971-4471 |
Second Address | Fyffe, AL 35971-4471 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2009 |
Last Update Date | 05/06/2009 |