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NPI Code Detail

MEDICARE: KIMBERLY DAWN SKELTON PTA

MEDICARE: KIMBERLY DAWN SKELTON PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant3590NC

General Provider Information

NPI Number : 1326249632
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY DAWN SKELTON PTA
Provider Business Mailing Address
First Line : 701 E FRANKLIN ST
Second Line : APT 1
City : RALEIGH
State : NC
Zip : 27604-1976
Country : US
Telephone Number : 304-617-2120
Fax Number :
Provider Business Practice Location Address
First Line : 3830 BLUE RIDGE RD
Second Line :
City : RALEIGH
State : NC
Zip : 27612-4319
Country : US
Telephone Number : 304-617-2120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY DAWN SKELTON PTA” Practice Location

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