Individual
MRS. KIMBERLY ANN FISCUS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
14415 SAINT GERMAIN DR, CENTREVILLE, VA 20121-2223
(703) 266-1897
Mailing address
914 OVERLOOK PL, ALTOONA, PA 16602-6942
(814) 381-6426
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000047
VA
Other
Enumeration date
03/25/2006
Last updated
07/08/2007
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