Individual
LINDA ANN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, ECS, CHT
Contact information
Practice address
2109 N PATTERSON ST, SUITE A, VALDOSTA, GA 31602-2946
(229) 247-5225
(229) 241-8471
Mailing address
2109 N PATTERSON ST, SUITE A, VALDOSTA, GA 31602-2946
(229) 247-5225
(229) 241-8471
Taxonomy
Speciality
Code
Description
License number
State
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
PT000951
GA
2251H1200X
Hand Physical Therapist
PT000951
GA
2251X0800X
Orthopedic Physical Therapist
PT000951
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101820
BLUE CROSS BLUE SHIELD
GA
01
—
CL3489
RAILROAD MEDICARE
GA
01
—
GRP3435
MEDICARE GROUP NUMBER
GA
Enumeration date
11/03/2005
Last updated
09/27/2007
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