Healthcare Provider Details

I. General information

NPI: 1407961477
Provider Name (Legal Business Name): CHRISTINA BERBEN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5477 GERMANNA HWY
LOCUST GROVE VA
22508-2018
US

IV. Provider business mailing address

5477 GERMANNA HWY
LOCUST GROVE VA
22508-2018
US

V. Phone/Fax

Practice location:
  • Phone: 540-972-9610
  • Fax: 540-972-9516
Mailing address:
  • Phone: 540-972-9610
  • Fax: 540-972-9516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305204769
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: