Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 12760 | NC |
N | 2251N0400X | Physical Therapist - Neurology | 12760 | NC |
N | 2251P0200X | Physical Therapist - Pediatrics | 12760 | NC |
Y | 2251P0200X | Physical Therapist - Pediatrics | PT-6066 | MS |
N | 2251X0800X | Physical Therapist - Orthopedic | 12760 | NC |
NPI | 1730416678 |
---|---|
Provider Name | Virginia Claire Kolvites |
First Address | Hattiesburg, MS 39402-3317 |
Second Address | Hattiesburg, MS 39402-3317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2009 |
Last Update Date | 22/08/2016 |