Provider Demographics
NPI:1295040574
Name:MILLER, KRISTINA LEE (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PINE TREE LN
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-8706
Mailing Address - Country:US
Mailing Address - Phone:540-290-0296
Mailing Address - Fax:
Practice Address - Street 1:63 PINE TREE LN
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-8706
Practice Address - Country:US
Practice Address - Phone:540-290-0296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306602917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist