Individual
MRS. KIMBERLY DAWN KOTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
10124 WEST BROAD ST., SUITE O, GLEN ALLEN, VA 23060-3330
(866) 203-4365
(866) 204-5425
Mailing address
9111 ATLEE LAKE CT., MECHANICSVILLE, VA 23116-2871
(804) 789-9630
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305004593
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305004593
STATE LICENSE
VA
Enumeration date
04/03/2007
Last updated
07/10/2007
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