Provider Demographics
NPI:1164523676
Name:SABOL, KRISTEN ELIZABETH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:SABOL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:DELAMATRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3101 W US RT 224
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44836
Mailing Address - Country:US
Mailing Address - Phone:419-443-1429
Mailing Address - Fax:419-443-1691
Practice Address - Street 1:3101 W US RT 224
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44836
Practice Address - Country:US
Practice Address - Phone:419-443-1429
Practice Address - Fax:419-443-1691
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1442035OtherBWC
OH2527699Medicaid
OH1442035OtherBWC