Individual
MRS. KRISTINE M VILLARTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
10 SAINT PATRICKS DR, SUITE 401, WALDORF, MD 20603-4527
(301) 870-6717
(301) 870-7366
Mailing address
7503 SURRATTS RD, CLINTON, MD 20735-3358
(301) 870-7001
(302) 870-6697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
21032
MD
225100000X
Physical Therapist
Primary
2305213251
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404485100
—
MD
Enumeration date
09/27/2005
Last updated
10/25/2019
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