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Contact Information

MOUNTAIN KIDS, INC.
200 EAST RIVERSIDE DRIVE
NORTH TAZEWELL, VA24630
 Phone: 276-988-5583
 Fax: 276-979-1441
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MOUNTAIN KIDS INC · (Female)

NPI # 1235140716
Status Active
Credentials
Entity Individual
Enumeration date 08/10/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 0401411127
  • VA Medicaid 9182558
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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