Basic Information
| Provider Information | |||||||||
| NPI: | 1215039813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BONDS | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | P.T.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7726 OLD BAGLEY RD | ||||||||
| Address2: | |||||||||
| City: | EMPIRE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350635106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056314002 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1603 DECATUR HWY | ||||||||
| Address2: | STE 103 | ||||||||
| City: | GARDENDALE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350712302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056314002 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 19676 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.