| Doctor Name: | MS. KIMBERLY A MAZIK |
| NPI Number: | 1801884499 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 1168 |
| Business Practice Address: | 1014 Business Park Dr Suite A Hailey, ID - 833335233 |
| Business Phone Number: | 2087886312 |
| Business Fax Number: | 2085781053 |
| Mailing Address: | 1014 Business Park Dr Ste A, Po Box 5786 HAILEY |
| State: | ID |
| Postal Code: | 833335233 |
| Phone Number: | 2087886312 |
| Fax Number: | 2085781053 |
| NPI Enumeration Date: | 10/08/2005 |
| NPI Last Update Date: | 03/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 1168 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |