Individual
TIMOTHY D KIBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
515 RAY C HUNT DR, CHARLOTTESVILLE, VA 22903-2981
(434) 244-2015
(434) 243-0320
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004761
VA
225XH1200X
Hand Occupational Therapist
0119004761
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336396720
—
VA
01
—
P00804354
RR MEDICARE
VA
Enumeration date
08/27/2008
Last updated
08/14/2019
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