Provider Demographics
NPI:1710271929
Name:MITCHELL, CHRISTINE F (DPT)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:F
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:FULLERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:803 W BROAD ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3130
Mailing Address - Country:US
Mailing Address - Phone:703-237-2000
Mailing Address - Fax:703-237-2155
Practice Address - Street 1:803 W BROAD ST
Practice Address - Street 2:SUITE 600
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3130
Practice Address - Country:US
Practice Address - Phone:703-237-2000
Practice Address - Fax:703-237-2155
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206894225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist