Provider Demographics
NPI:1497270441
Name:PARKINS, KRISTEN RENEE (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RENEE
Last Name:PARKINS
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 1:1010 WOODMAN DR STE 110
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1429
Mailing Address - Country:US
Mailing Address - Phone:937-813-7575
Mailing Address - Fax:937-813-8497
Practice Address - Street 1:1407 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3159
Practice Address - Country:US
Practice Address - Phone:240-813-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017141225100000X
PAPT026337225100000X
MD29391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist