Healthcare Provider Details

I. General information

NPI: 1861081820
Provider Name (Legal Business Name): KAITLYN MECHLING DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 TWINRIDGE LN STE A
NORTH CHESTERFIELD VA
23235-5200
US

IV. Provider business mailing address

206 TWINRIDGE LN STE A
NORTH CHESTERFIELD VA
23235-5200
US

V. Phone/Fax

Practice location:
  • Phone: 804-323-7576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305209525
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: