Provider Demographics
NPI:1174048425
Name:MASSEY, KRISTA LINNEA (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:LINNEA
Last Name:MASSEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:LINNEA
Other - Last Name:MYHRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 EDDIE CHASTEEN DR
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-5728
Mailing Address - Country:US
Mailing Address - Phone:843-539-1111
Mailing Address - Fax:
Practice Address - Street 1:211 EDDIE CHASTEEN DR
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-5728
Practice Address - Country:US
Practice Address - Phone:843-539-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor