Provider Demographics
NPI:1699103374
Name:UY, MICHELLE KIMBERLY (DPT)
Entity type:Individual
Prefix:MS
First Name:MICHELLE KIMBERLY
Middle Name:
Last Name:UY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 JEFFERSON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CLIFTON FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:24422-1464
Mailing Address - Country:US
Mailing Address - Phone:513-384-8674
Mailing Address - Fax:
Practice Address - Street 1:1725 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON FORGE
Practice Address - State:VA
Practice Address - Zip Code:24422-1905
Practice Address - Country:US
Practice Address - Phone:540-862-5791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208818225100000X
WVPT 003117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist