Basic Information
Provider Information
NPI: 1922614767
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SILSBY
FirstName: KRISTEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1769
Address2:  
City: MIDDLEBURG
State: VA
PostalCode: 201181769
CountryCode: US
TelephoneNumber: 7035460013
FaxNumber: 7035460014
Practice Location
Address1: 7764 ARMISTEAD RD STE 210
Address2:  
City: LORTON
State: VA
PostalCode: 220791961
CountryCode: US
TelephoneNumber: 7035460013
FaxNumber: 7035460014
Other Information
ProviderEnumerationDate: 09/17/2020
LastUpdateDate: 11/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305214017VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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