Provider Demographics
NPI:1598073850
Name:KRS-PT, INC.
Entity Type:Organization
Organization Name:KRS-PT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REHA
Authorized Official - Middle Name:CHANDRAKANT
Authorized Official - Last Name:SHRIKHANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:714-926-1913
Mailing Address - Street 1:PO BOX 28682
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0156
Mailing Address - Country:US
Mailing Address - Phone:714-926-1913
Mailing Address - Fax:866-903-8974
Practice Address - Street 1:12670 STANTON AVE
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1027
Practice Address - Country:US
Practice Address - Phone:714-926-1913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29649261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy