Individual
KATHLEEN KELLEHER MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
9447B LORTON MARKET ST, SUITE 250, LORTON, VA 22079-1963
(703) 372-5716
(703) 372-5718
Mailing address
9123 VOLUNTEER DR, ALEXANDRIA, VA 22309-2922
(916) 487-3473
(916) 487-3483
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208262
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 33916
PHYSICAL THERAPY
CA
Enumeration date
01/25/2007
Last updated
10/17/2013
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