Individual
MRS. KIMBERLY S GOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
930 S MAIN ST, BLACKSTONE, VA 23824-2614
(434) 292-4167
(434) 292-7554
Mailing address
PO BOX 238, BLACKSTONE, VA 23824-0238
(434) 292-4167
(434) 292-7554
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002622
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196190
ANTHEM
VA
01
—
386601
ANTHEM
VA
Enumeration date
07/28/2005
Last updated
01/04/2012
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