Kimberly Ann Dejoe, MPT
Individual provider Active NPI Physical Therapist · Troy, MO
NPI 1902906704 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1902906704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2004001632 (MO)
- Practice address
- 108 Professional Pkwy
Troy, MO 63379-2823 - Phone
- (636) 528-6080
- Fax
- (636) 528-3973
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Rehabilitation Services, LLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2004001632 | MO | Yes |
Addresses
Primary practice location
108 Professional Pkwy
Troy, MO 63379-2823
Mailing address
108 Professional Parkway Drive
Troy, MO 63379-2823
Phone (636) 528-6080
Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.