Provider Demographics
NPI:1619004553
Name:SAUL, KIMBERLY (LAC,DIPLAC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SAUL
Suffix:
Gender:F
Credentials:LAC,DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8402
Mailing Address - Country:US
Mailing Address - Phone:770-962-0228
Mailing Address - Fax:
Practice Address - Street 1:287 SCENIC HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8402
Practice Address - Country:US
Practice Address - Phone:770-962-0228
Practice Address - Fax:700-962-4181
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA155171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist