Healthcare Provider Details

I. General information

NPI: 1497920581
Provider Name (Legal Business Name): KRISTA M CINKALA LICENSED PHYSICAL TH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 WILLIAMSON ROAD HEARTLAND REHABILITATION SERVICES OF VIRGINIA NORTH ROA
ROANOKE VA
24019
US

IV. Provider business mailing address

1403 MILL RACE DRIVE HEARTLAND REHABILITATION SERVICES OF VIRGINIA
SALEM VA
24153
US

V. Phone/Fax

Practice location:
  • Phone: 540-366-2243
  • Fax: 540-366-4801
Mailing address:
  • Phone: 540-444-0526
  • Fax: 540-444-0531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306001199
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: