| Doctor Name: | KIM CHAMPINE YOURICK |
| NPI Number: | 1821419854 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MBA, PT |
| License Number: | 1031870 |
| Business Practice Address: | 4411 Suwanee Dam Rd Suite 330 Suwanee, GA - 300248701 |
| Business Phone Number: | 7709042332 |
| Business Fax Number: | |
| Mailing Address: | 3400 Mainstay Pl, ALPHARETTA |
| State: | GA |
| Postal Code: | 300222417 |
| Phone Number: | 6783660183 |
| Fax Number: | |
| NPI Enumeration Date: | 12/17/2013 |
| NPI Last Update Date: | 12/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1031870 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| 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 |