Provider Demographics
NPI:1548547987
Name:GREGORY, KIMBERLY (MPT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ALMSHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1108
Mailing Address - Country:US
Mailing Address - Phone:215-357-2000
Mailing Address - Fax:215-357-8499
Practice Address - Street 1:100 ALMSHOUSE RD
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1108
Practice Address - Country:US
Practice Address - Phone:215-357-2000
Practice Address - Fax:215-357-8499
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008022L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist