Provider Demographics
NPI:1184014557
Name:FARR, KIRSTEN (ATC, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4240
Mailing Address - Country:US
Mailing Address - Phone:864-242-4263
Mailing Address - Fax:864-242-2250
Practice Address - Street 1:1011 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4240
Practice Address - Country:US
Practice Address - Phone:864-242-4263
Practice Address - Fax:864-242-2250
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer