Healthcare Provider Details

I. General information

NPI: 1851823249
Provider Name (Legal Business Name): CHRISTINA SMITH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9003 TWEED RD
RICHMOND VA
23228-1507
US

IV. Provider business mailing address

9003 TWEED RD
RICHMOND VA
23228-1507
US

V. Phone/Fax

Practice location:
  • Phone: 804-764-7021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305210390
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: