Provider Demographics
NPI:1932792165
Name:FAT, KRISS LENDINI LENDINI (LMT)
Entity Type:Individual
Prefix:
First Name:KRISS LENDINI
Middle Name:LENDINI
Last Name:FAT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 WINTERS HILL CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-2379
Mailing Address - Country:US
Mailing Address - Phone:804-496-9065
Mailing Address - Fax:
Practice Address - Street 1:2103 E PARHAM RD STE 104H
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2235
Practice Address - Country:US
Practice Address - Phone:804-497-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019012262225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist