Provider Demographics
NPI:1396515532
Name:AYCOCK, KIMBER LEIGH (CFO)
Entity type:Individual
Prefix:MRS
First Name:KIMBER
Middle Name:LEIGH
Last Name:AYCOCK
Suffix:
Gender:F
Credentials:CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4754
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-4754
Mailing Address - Country:US
Mailing Address - Phone:910-295-2828
Mailing Address - Fax:910-295-2996
Practice Address - Street 1:325 PAGE RD N BLDG 3
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-4637
Practice Address - Country:US
Practice Address - Phone:910-295-2828
Practice Address - Fax:910-295-2996
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter