Provider Demographics
NPI:1720755150
Name:WEBB, KRISTEN
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CHURCH ROAD
Mailing Address - State:VA
Mailing Address - Zip Code:23833-2742
Mailing Address - Country:US
Mailing Address - Phone:804-896-5818
Mailing Address - Fax:
Practice Address - Street 1:7415 LEE DAVIS RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-4405
Practice Address - Country:US
Practice Address - Phone:804-559-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213567225100000X
SCCP032025T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist