Provider Demographics
NPI:1033439534
Name:TOME, KRISTEN (ATC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:TOME
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 E GRANDVIEW BLVD
Mailing Address - Street 2:APT 204
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-2629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4671 W LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-1441
Practice Address - Country:US
Practice Address - Phone:814-835-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0035362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer