Provider Demographics
NPI:1659491231
Name:GLEASON-HINK, KIMBERLY KAY (MA,PT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:KAY
Last Name:GLEASON-HINK
Suffix:
Gender:F
Credentials:MA,PT
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:KAY
Other - Last Name:GLEASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 LANTERN CIR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7309
Mailing Address - Country:US
Mailing Address - Phone:717-626-0943
Mailing Address - Fax:
Practice Address - Street 1:722 FURNACE HILLS PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7954
Practice Address - Country:US
Practice Address - Phone:717-626-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist