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1821016890
KELLY DEAN BIRT
LYNCHBURG, VA
NPI
1821016890
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110001545)
Enumeration Date
2006-07-18
Last Update Date
2007-10-29
Business Address
-- KELLY DEAN BIRT PA
113 NATIONWIDE DR
LYNCHBURG, VA 24502-4272
Phone number: 434-237-4004
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Mailing Address
-- KELLY DEAN BIRT PA
113 NATIONWIDE DR
LYNCHBURG, VA 24502-4272
Phone number: 434-237-4004
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