Individual
MRS. KELLIE ANNE WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6201 CENTREVILLE RD STE 600, CENTREVILLE, VA 20121-2634
(703) 435-6604
Mailing address
6201 CENTREVILLE RD STE 600, CENTREVILLE, VA 20121-2634
(703) 435-6604
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602825
VA
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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