Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305209493 | VA |
N | 2251N0400X | Physical Therapist - Neurology | 2305209493 | VA |
NPI | 1780277483 |
---|---|
Provider Name | Dr. Kelley Anne Stobbs |
First Address | Virginia Beach, VA 23452-7615 |
Second Address | Virginia Beach, VA 23451-3905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2021 |
Last Update Date | 22/03/2021 |