Provider Demographics
NPI:1174813687
Name:SALVATO, KRISTY MARIE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:MARIE
Last Name:SALVATO
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2478 HEATHERLEAF LN
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4336
Mailing Address - Country:US
Mailing Address - Phone:925-575-1197
Mailing Address - Fax:
Practice Address - Street 1:2478 HEATHERLEAF LN
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4336
Practice Address - Country:US
Practice Address - Phone:925-575-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11232174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist