Provider Demographics
NPI:1255804878
Name:MUSSER, KRISTOPHER
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:
Last Name:MUSSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 CARROLLTON PIKE
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-3891
Mailing Address - Country:US
Mailing Address - Phone:276-728-0700
Mailing Address - Fax:276-728-0755
Practice Address - Street 1:1113 CARROLLTON PIKE
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-3891
Practice Address - Country:US
Practice Address - Phone:276-728-0700
Practice Address - Fax:276-728-0755
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist