Provider Demographics
NPI:1164145306
Name:SATRA, KRISTA AUTUMN (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:AUTUMN
Last Name:SATRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 GODWIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8037
Mailing Address - Country:US
Mailing Address - Phone:757-934-4653
Mailing Address - Fax:757-934-4594
Practice Address - Street 1:2769 GODWIN BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8037
Practice Address - Country:US
Practice Address - Phone:757-934-4653
Practice Address - Fax:757-934-4594
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA014557856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor