Provider Demographics
NPI:1962725671
Name:SWARTHOUT HAMILTON, KIMBERLEA S (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEA
Middle Name:S
Last Name:SWARTHOUT HAMILTON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:KIMBERLEA
Other - Middle Name:SUE
Other - Last Name:SWARTHOUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4011 N FRESNO ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4028
Mailing Address - Country:US
Mailing Address - Phone:559-227-4440
Mailing Address - Fax:559-227-4443
Practice Address - Street 1:4011 N FRESNO ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4028
Practice Address - Country:US
Practice Address - Phone:559-227-4440
Practice Address - Fax:559-227-4443
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10244225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10244OtherPT LICENSE