Basic Information
| Provider Information | |||||||||
| NPI: | 1992723670 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | CRISTIN | ||||||||
| MiddleName: | RAYE | ||||||||
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| Credential: | PT DPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JACKSON | ||||||||
| OtherFirstName: | CRISTIN | ||||||||
| OtherMiddleName: | RAYE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11240 WAPLES MILL RD | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033854707 | ||||||||
| FaxNumber: | 7036914933 | ||||||||
| Practice Location | |||||||||
| Address1: | 1635 N GEORGE MASON DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222053601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038105216 | ||||||||
| FaxNumber: | 7038105494 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 10/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305204406 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.