Individual
MR. SKYLAR TREVOR KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
110 LAUCK DR, WINCHESTER, VA 22603-4282
(540) 667-7830
Mailing address
553 GOOD DR, MARTINSBURG, WV 25405-5054
(240) 382-8313
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603478
VA
225200000X
Physical Therapy Assistant
A3863
MD
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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