Provider Demographics
NPI:1821197773
Name:ROBINSON, KRISTI JEAN (LPT)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:JEAN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11174 WATERVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571-9800
Mailing Address - Country:US
Mailing Address - Phone:419-350-3004
Mailing Address - Fax:419-877-0208
Practice Address - Street 1:11174 WATERVILLE ST
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9800
Practice Address - Country:US
Practice Address - Phone:419-350-3004
Practice Address - Fax:419-877-0208
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist