Individual
KAREN SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
389 KANE STREET, GATE CITY, VA 24251
(276) 386-2424
(276) 386-2349
Mailing address
PO BOX 1807, 389 KANE STREET, GATE CITY, VA 24251-4807
(276) 386-2424
(276) 386-2349
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003367
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119003367
VIRGINIA LICENSE
VA
Enumeration date
03/27/2014
Last updated
03/27/2014
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