Provider Demographics
NPI:1104148915
Name:KLEIMAN, KIMBERLY A (MAC, LAC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:KLEIMAN
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:KYM
Other - Middle Name:
Other - Last Name:KLEIMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAC, LAC
Mailing Address - Street 1:1601 N TUCSON BLVD STE 14
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3406
Mailing Address - Country:US
Mailing Address - Phone:520-323-7060
Mailing Address - Fax:520-323-6175
Practice Address - Street 1:1601 N TUCSON BLVD STE 14
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3406
Practice Address - Country:US
Practice Address - Phone:520-323-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0623171100000X
ORAC01298171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist