Individual
DR. MICHELLE HEIDI KOTKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1809 PLAZA DR, WINCHESTER, VA 22601
(540) 667-7300
(540) 667-0567
Mailing address
1809 PLAZA DR, WINCHESTER, VA 22601
(540) 667-7300
(540) 667-0567
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001317
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0132119000
—
WV
05
—
0300055
—
VA
01
—
14521
OPTIMA
VA
01
—
203058
ANTHEM
—
01
—
505187
HEALTH LINK NCPPO
—
01
—
601858500
US DEPT OF LABOR
—
Enumeration date
12/28/2005
Last updated
08/19/2010
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