Provider Demographics
NPI:1235628207
Name:LITTEL, KRISTOPHER JOSEPH
Entity Type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:JOSEPH
Last Name:LITTEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 LANGDON ST APT 203
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1208
Mailing Address - Country:US
Mailing Address - Phone:920-471-7476
Mailing Address - Fax:
Practice Address - Street 1:1440 MONROE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2051
Practice Address - Country:US
Practice Address - Phone:608-264-8065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer