Provider Demographics
NPI:1912203084
Name:OHLER, KRISTINE LYNN (BS, PTA)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:LYNN
Last Name:OHLER
Suffix:
Gender:F
Credentials:BS, PTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 2327
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-8327
Mailing Address - Country:US
Mailing Address - Phone:301-997-1155
Mailing Address - Fax:301-997-1199
Practice Address - Street 1:40900 MERCHANTS LN
Practice Address - Street 2:SUITE 202
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-3795
Practice Address - Country:US
Practice Address - Phone:301-997-1155
Practice Address - Fax:301-997-1199
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPTAA2289225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant