| Doctor Name: | MS. NICOLE ATHENA KIMBALL |
| NPI Number: | 1437218856 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS PT |
| License Number: | 0193081 |
| Business Practice Address: | 1313 W Park Street Suite # 7 Livingston, MT - 59047 |
| Business Phone Number: | 4062225519 |
| Business Fax Number: | 4062220366 |
| Mailing Address: | 618 N 3rd, BOZEMAN |
| State: | MT |
| Postal Code: | 59715 |
| Phone Number: | 4065700535 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 0193081 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |