Individual
MRS. REBECCA COYLE BERTHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
290 MASSIE ROAD, CHARLOTTESVILLE, VA 22904
(434) 982-5450
Mailing address
5120 BUTE ST, CHESAPEAKE, VA 23321-1586
(904) 631-5004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001321
VA
Other
Enumeration date
03/06/2009
Last updated
01/29/2013
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