Basic Information
| Provider Information | |||||||||
| NPI: | 1093149361 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KIBLER | ||||||||
| FirstName: | THERESA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2705 N LEBANON ST STE 305 | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460528622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654858853 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2485 E WABASH ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654858100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05011198A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.