Provider Demographics
NPI:1598842049
Name:GERRETY, KRISTIN SIEGFRIED (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:SIEGFRIED
Last Name:GERRETY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 MERRIMON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLEQ
Mailing Address - State:NC
Mailing Address - Zip Code:28804-2405
Mailing Address - Country:US
Mailing Address - Phone:828-251-6091
Mailing Address - Fax:828-251-6911
Practice Address - Street 1:852 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2405
Practice Address - Country:US
Practice Address - Phone:828-251-6091
Practice Address - Fax:828-251-6911
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011592225100000X
NCP145692251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist