Provider Demographics
NPI:1285207779
Name:KASKIE, KRISTIN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:KASKIE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 RACETRACK RD NW STE 20
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1581
Mailing Address - Country:US
Mailing Address - Phone:850-374-8158
Mailing Address - Fax:850-374-8164
Practice Address - Street 1:339 RACETRACK RD NW STE 20
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1581
Practice Address - Country:US
Practice Address - Phone:850-374-8158
Practice Address - Fax:850-374-8164
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27684225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT27684OtherPT LICENSE