Provider Demographics
NPI:1861675498
Name:VANG, KRIS MAY (PT)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:MAY
Last Name:VANG
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 1:106 BLOSSOM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7169
Mailing Address - Country:US
Mailing Address - Phone:470-559-2825
Mailing Address - Fax:
Practice Address - Street 1:106 BLOSSOM CREEK DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7169
Practice Address - Country:US
Practice Address - Phone:470-559-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008852225100000X
NCP15274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist