Provider Demographics
NPI:1346893351
Name:MANSFIELD, KRISTINE STRUTTON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:STRUTTON
Last Name:MANSFIELD
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 1:122 EAGLES NEST DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-2989
Mailing Address - Country:US
Mailing Address - Phone:919-316-8739
Mailing Address - Fax:336-538-7529
Practice Address - Street 1:101 THOMAS LN APT C2
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1362
Practice Address - Country:US
Practice Address - Phone:919-590-0857
Practice Address - Fax:919-883-5471
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP6729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist