Provider Demographics
NPI:1023217791
Name:LAUMER, KRISTA MARIE (DPT PT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MARIE
Last Name:LAUMER
Suffix:
Gender:F
Credentials:DPT PT
Other - Prefix:MS
Other - First Name:KRISTA
Other - Middle Name:MARIE
Other - Last Name:MATHIOWETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT PT
Mailing Address - Street 1:1513 HANSEN DR SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201
Mailing Address - Country:US
Mailing Address - Phone:320-235-1877
Mailing Address - Fax:
Practice Address - Street 1:96 3RD ST E
Practice Address - Street 2:
Practice Address - City:MORGAN
Practice Address - State:MN
Practice Address - Zip Code:56266
Practice Address - Country:US
Practice Address - Phone:507-249-3143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist