Individual
MR. KURT EUGENE THIELE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., ATC, LAT
Contact information
Practice address
1 CAVALIER CIR, FOREST, VA 24551-2206
(540) 680-9732
Mailing address
1055 COLUMN WAY APT 203, FOREST, VA 24551-1885
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126002622
VA
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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