1952717860 NPI number — KIBLER HAND THERAPY, LLC

Table of content: (NPI 1952717860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952717860 NPI number — KIBLER HAND THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIBLER HAND THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952717860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
69 DEANE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUCKERSVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22968-3482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-421-7280
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
69 DEANE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUCKERSVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22968-3482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-421-7280
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2014

Additional Information

Authorized Official

Authorized Official Last Name:
KIBLER
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
540-421-7280

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  0119004761 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1336396720 . This is a "IND NPI" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com