Provider Demographics
NPI:1568694743
Name:STAPLER, CRISTIN A (DPT)
Entity Type:Individual
Prefix:
First Name:CRISTIN
Middle Name:A
Last Name:STAPLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CRISTIN
Other - Middle Name:A
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:614 WESTPORT RD STE A
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3832
Mailing Address - Country:US
Mailing Address - Phone:270-360-9129
Mailing Address - Fax:270-234-8197
Practice Address - Street 1:505 HIGH ST
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1317
Practice Address - Country:US
Practice Address - Phone:270-422-5004
Practice Address - Fax:270-422-5002
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7803208100000X
TX1243843208100000X
MA187252251X0800X
KY007803225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic