Provider Demographics
NPI:1548524804
Name:GREER, KIMBERLY G (LPTA)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:G
Last Name:GREER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 LAURENDALE CT
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-3344
Mailing Address - Country:US
Mailing Address - Phone:910-585-3039
Mailing Address - Fax:
Practice Address - Street 1:2173 MURDOCKSVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-8820
Practice Address - Country:US
Practice Address - Phone:910-690-4542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251500000X225200000X
NC882225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant