Provider Demographics
NPI:1255856597
Name:GRAZIER, KRISTEN HELENE (DPT)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:HELENE
Last Name:GRAZIER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7036 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5409
Mailing Address - Country:US
Mailing Address - Phone:646-852-0192
Mailing Address - Fax:602-249-4115
Practice Address - Street 1:7540 N 19TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7967
Practice Address - Country:US
Practice Address - Phone:602-249-9129
Practice Address - Fax:602-249-4115
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01741500225100000X
AZLPT-013472225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist