Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2305210214 | VA |
N | 2081S0010X | Sports Medicine | 2305210214 | VA |
N | 213ES0000X | Sports Medicine | 2305210214 | VA |
NPI | 1497102545 |
---|---|
Provider Name | Kara Sims |
First Address | Stafford, VA 22555-1872 |
Second Address | Stafford, VA 22554-8323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2016 |
Last Update Date | 18/05/2016 |