Provider Demographics
NPI:1063494300
Name:IVES, KRISTIN V (PT)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:V
Last Name:IVES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W CRISER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-2360
Mailing Address - Country:US
Mailing Address - Phone:540-636-4592
Mailing Address - Fax:540-636-8161
Practice Address - Street 1:209 W CRISER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-2360
Practice Address - Country:US
Practice Address - Phone:540-636-4592
Practice Address - Fax:540-636-8161
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050007592251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics