National Provider Identifier

Kimberley Ann Clark, PT

Kimberley Ann Clark, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Canandaigua, NY and a listed phone number of (585) 394-9510.

NPI 1225280886Canandaigua, NYPhysical Therapist

Profile Overview

NPI
1225280886
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
October 15, 2008
Last Updated
October 15, 2008

Practice Location

  • 5415 County Road 30
  • Canandaigua, NY 14424-7964

Phone: (585) 394-9510

Mailing Address

  • 68 Princeton Ln
  • Fairport, NY 14450-9027

Specialties

  • Physical Therapist (225100000X)
Full Record
NPI
1225280886
Entity Type
Individual
Last Name
Clark
First Name
Kimberley
Middle Name
Ann
Name Prefix
Mrs.
Credential
PT
Provider Other Last Name
Brhel
Provider Other First Name
Kimberley
Provider Other Middle Name
Ann
Provider Other Last Name Type Code
1
Mailing Street Address
68 Princeton Ln
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-9027
Mailing Country
US
Mailing Phone
(585) 598-3092
Practice Street Address
5415 County Road 30
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-7964
Practice Country
US
Practice Phone
(585) 394-9510
Enumeration Date
October 15, 2008
Last Updated
October 15, 2008
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X)