Provider Demographics
NPI:1417906884
Name:KUTINA, KRISTA L (PT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:KUTINA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10861 HAMILTON CLUB DR
Mailing Address - Street 2:APT 304
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8528
Mailing Address - Country:US
Mailing Address - Phone:216-374-5775
Mailing Address - Fax:
Practice Address - Street 1:10861 HAMILTON CLUB DR
Practice Address - Street 2:APT 304
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8528
Practice Address - Country:US
Practice Address - Phone:216-374-5775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist