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General NPI Number Information
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NPI Number | 1619392990
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Entity Type | Individual
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Provider Name | KIMBERLY PARKS
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Gender | Female
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 8020 RIVER STONE DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-8761
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Country | US
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Telephone | 540-834-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 245 WASHINGTON DR
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City | RUTHER GLEN
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State | VA
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Zip | 22546-5155
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Country | US
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Telephone | 845-866-4339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305208137
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License Number State | VA
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