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General NPI Number Information
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NPI Number | 1700697778
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Entity Type | Individual
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Provider Name | KRYSTAL FRANKLIN PTA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 456 CHARLES H DIMMOCK PKWY STE 1
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2936
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Country | US
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Telephone | 804-520-8366
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Fax |
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Provider Business Mailing Address
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Address Line | 10212 SALEM OAKS PL
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23237-3855
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306606026
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License Number State | VA
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