Blackwell, Kim

Blackwell, Kim is an individual health care provider with primary practice located at 1101 5Th St Suite 100, Coralville IA 52241-2903. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Blackwell, Kim can be contacted via phone (319) 341-3442.

Contact Information

Primary practice address
1101 5Th St Suite 100 Coralville IA 52241-2903
Phone: (319) 341-3442
Fax: (319) 341-0836
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 03654

Profile Details

NPI number 1851428130
LBN Legal business name Blackwell, Kim
Credentials LPT
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851428130 NPPES
Iowa MEDICAID 0665463

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