Kettler, Kimbraly A

Kettler, Kimbraly A is an individual health care provider with primary practice located at 4603 Timberwalk Ct , La Grange KY 40031-6746. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Kettler, Kimbraly A can be contacted via phone (703) 864-6695.

Contact Information

Primary practice address
4603 Timberwalk Ct La Grange KY 40031-6746
Phone: (703) 864-6695
Fax: (888) 830-3233
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 007521 Kentucky

Profile Details

NPI number 1659498038
LBN Legal business name Kettler, Kimbraly A
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2007
Last updated Feb 27th, 2020 - about 5 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 1659498038 NPPES
West Virginia Other 002097665 MT STATE BCBS
West Virginia Other 1073906 MT STATE BCBS
West Virginia Other PT002705 MT STATE BCBS

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