Provider Demographics
NPI:1598017501
Name:LANDERS, KRISTEN Z (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:Z
Last Name:LANDERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:ZIELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:540-687-8181
Mailing Address - Fax:540-687-8256
Practice Address - Street 1:209 MADISON ST
Practice Address - Street 2:SUITE LL2
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1764
Practice Address - Country:US
Practice Address - Phone:703-299-6688
Practice Address - Fax:703-299-3588
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist