Individual
MISS KELLIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1785 S HAYES ST, ARLINGTON, VA 22202-2714
(703) 685-3000
(703) 625-0741
Mailing address
1785 S HAYES ST, ARLINGTON, VA 22202-2714
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602846
VA
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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