MEDICARE: CHRISTINA SMITH MPT, ATC, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT870591	DC
2	225100000X	Physical Therapist	2305203188	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F8710006	OTHER	DC	CAREFIRST BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1184640989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA SMITH MPT, ATC, CSCS

Provider Business Mailing Address
First Line	:	225 REINEKERS LN STE GR4
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2871
Country	:	US
Telephone Number	:	703-299-3111
Fax Number	:	703-299-1556

Provider Business Practice Location Address
First Line	:	225 REINEKERS LN STE GR4
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2871
Country	:	US
Telephone Number	:	703-299-3111
Fax Number	:	703-299-1556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	10/24/2017

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Directions to “ CHRISTINA SMITH MPT, ATC, CSCS” Practice Location

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