Provider Demographics
NPI:1588607584
Name:STRANE, CARISSA B (PT)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:B
Last Name:STRANE
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 1:2034 DABNEY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3361
Mailing Address - Country:US
Mailing Address - Phone:804-523-2653
Mailing Address - Fax:804-783-8212
Practice Address - Street 1:2034 DABNEY RD
Practice Address - Street 2:SUITE D
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3361
Practice Address - Country:US
Practice Address - Phone:804-523-2653
Practice Address - Fax:804-783-8212
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305202941OtherVA LICENSE