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General NPI Number Information
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NPI Number | 1831313246
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Entity Type | Individual
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Provider Name | KRISTA BETH RECORDS PTA
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 E CARROLL ST
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City | SALISBURY
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State | MD
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Zip | 21801-5422
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Country | US
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Telephone | 410-543-7069
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Fax |
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Provider Business Mailing Address
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Address Line | 407 DELAWARE AVE
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City | DELMAR
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State | DE
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Zip | 19940-1208
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Country | US
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Telephone | 302-846-3352
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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 | A2427
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License Number State | MD
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