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General NPI Number Information
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NPI Number | 1144947771
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Entity Type | Organization
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Legal Business Name | WILLIAM CRIST WELLNESS LLC
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 11/06/2022
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Provider Practice Location Address
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Address Line | 4445 CORPORATION LN STE 264
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3262
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Country | US
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Telephone | 757-204-2691
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 GLENWOOD DR SE
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City | ROANOKE
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State | VA
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Zip | 24014-4403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | WILLIAM CRIST
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Credential | DPT
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Telephone | 434-989-9016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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