Provider Demographics
NPI:1710010111
Name:KINNEY, CHRISTINE LYNNE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNNE
Last Name:KINNEY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12525 GAYTON BLUFFS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-6640
Mailing Address - Country:US
Mailing Address - Phone:804-360-7080
Mailing Address - Fax:
Practice Address - Street 1:12525 GAYTON BLUFFS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-6640
Practice Address - Country:US
Practice Address - Phone:804-360-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist