Provider Demographics
NPI:1942649801
Name:OELSCHLEGAL, KRISTIN NICOLE (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICOLE
Last Name:OELSCHLEGAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E PIONEER AVE
Mailing Address - Street 2:STE 218
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7694
Mailing Address - Country:US
Mailing Address - Phone:951-696-9353
Mailing Address - Fax:951-973-7216
Practice Address - Street 1:31720 TEMECULA PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5802
Practice Address - Country:US
Practice Address - Phone:951-303-3566
Practice Address - Fax:951-303-3577
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1060312251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA112712Medicare PIN
CACA108726Medicare PIN