Provider Demographics
NPI:1598088205
Name:WORKMAN, KRISTEN K (PTA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:K
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5790 DENLINGER RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1838
Mailing Address - Country:US
Mailing Address - Phone:937-837-5581
Mailing Address - Fax:
Practice Address - Street 1:5790 DENLINGER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45426-1838
Practice Address - Country:US
Practice Address - Phone:937-837-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA 07055225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant