Provider Demographics
NPI:1487664975
Name:AYERS, KRISTIN RENEE (DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:RENEE
Last Name:AYERS
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 1:207 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1418
Mailing Address - Country:US
Mailing Address - Phone:602-531-0468
Mailing Address - Fax:
Practice Address - Street 1:1336 HIGHWAY 54 W BLDG 500
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4574
Practice Address - Country:US
Practice Address - Phone:770-461-1238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011192225100000X
AZ7246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist