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Individual

MRS. KRISTI CARROLL IRBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
10701 MAIN ST, FAIRFAX, VA 22030-6904
(703) 273-7705
Mailing address
9304 ASHMEADE DR, FAIRFAX, VA 22032-1304

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306000517
VA

Other

Enumeration date
11/02/2017
Last updated
11/02/2017
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