Provider Demographics
NPI:1326128299
Name:MOUNTS, KRISTI L (MS, ATC/L, CSCS)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:MOUNTS
Suffix:
Gender:F
Credentials:MS, ATC/L, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1276 WINDSOR GLEN DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2733
Mailing Address - Country:US
Mailing Address - Phone:770-577-3069
Mailing Address - Fax:
Practice Address - Street 1:1 WHITEFIELD DR SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5236
Practice Address - Country:US
Practice Address - Phone:678-305-1452
Practice Address - Fax:770-305-2915
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0012042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer