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1619588167
KIMBERLY DAWN PHOMSOPHA
LEESBURG, VA
NPI
1619588167
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: VA 2306603910)
Enumeration Date
2020-08-10
Last Update Date
2020-08-10
Business Address
KIMBERLY DAWN PHOMSOPHA PTA
44124 WOODRIDGE PKWY
LEESBURG, VA 20176-6935
Phone number: 703-729-4870
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Mailing Address
KIMBERLY DAWN PHOMSOPHA PTA
41269 LOVETTSVILLE RD
LOVETTSVILLE, VA 20180-2310
Phone number: 703-203-8552
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