Provider Demographics
NPI:1922344936
Name:MATHEWS, KRISTIN LEIGH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:LEIGH
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:LEIGH
Other - Last Name:HOLSING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:7223 COMMERCE ST STE 40
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3411
Practice Address - Country:US
Practice Address - Phone:703-935-1999
Practice Address - Fax:703-935-1997
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871396225100000X
VA2305213716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist