Provider Demographics
NPI:1730989666
Name:LINTON, DEJA CHARITA (PT, DPT)
Entity type:Individual
Prefix:
First Name:DEJA
Middle Name:CHARITA
Last Name:LINTON
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 MCBEE HWY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29718-9453
Mailing Address - Country:US
Mailing Address - Phone:843-622-4720
Mailing Address - Fax:
Practice Address - Street 1:42365 SOAVE DR STE 200
Practice Address - Street 2:
Practice Address - City:BRAMBLETON
Practice Address - State:VA
Practice Address - Zip Code:20148-4888
Practice Address - Country:US
Practice Address - Phone:571-349-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12728225100000X
VACP043048T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist