SearchIndiana2251X0800X

Jackie Kingma, DPT, ATC, PA-C, PT

NPI 1396718060 · on the registry since 2006

Practice

Address
1025 E 7th St
Hper C202
Bloomington, IN 47405
Phone
(812) 855-1233
Clinicians at this address
29

Registry record

Primary taxonomy
2251X0800X
2251X0800X
Also registered as
2255A2300X
363A00000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2012-10-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana