Provider Demographics
NPI:1821705914
Name:REMINGTON, KRISTINA KAY (LAC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:KAY
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7236
Mailing Address - Country:US
Mailing Address - Phone:561-706-6529
Mailing Address - Fax:
Practice Address - Street 1:2301 NE 45TH ST
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-7236
Practice Address - Country:US
Practice Address - Phone:561-706-6529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1417171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist