Provider Demographics
NPI:1073766994
Name:DAVIES, KRISTOPHER G (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:G
Last Name:DAVIES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-342-3758
Mailing Address - Fax:509-342-3761
Practice Address - Street 1:1695 S SAN JACINTO AVE
Practice Address - Street 2:SUITE C & D
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-5103
Practice Address - Country:US
Practice Address - Phone:951-665-1510
Practice Address - Fax:951-665-1515
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60241539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist