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Contact Information

JIM R KIMBAL, ATC, LAT, LMT, CSCS
1650 COWLES STREET
FMH REHAB DEPARTMENT
FAIRBANKS, AK99701
 Phone: 907-458-5670
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Massage Therapist

225700000X
Indicates primary specialty

NPI Profile & details for JIM R KIMBAL · (Male)

NPI Number 1114985322
Status Active
Credentials ATC, LAT, LMT, CSCS
Entity Individual
Enumeration date 05/04/2006
Last updated 09/28/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • AK License # 117476
  • AK License # 124560
  • IL License # 227005348
  • UT License # 10650493-4810
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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