Individual
KELLY DEAN BIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
113 NATIONWIDE DR, LYNCHBURG, VA 24502-4272
(434) 237-4004
(434) 237-4450
Mailing address
113 NATIONWIDE DR, LYNCHBURG, VA 24502-4272
(434) 237-4004
(434) 237-4450
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001545
VA
Other
Enumeration date
07/18/2006
Last updated
10/29/2007
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