Provider Demographics
NPI:1992025837
Name:WULFF, KRISTINA ANN (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANN
Last Name:WULFF
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:RR 1 BOX 140C
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9787
Mailing Address - Country:US
Mailing Address - Phone:570-265-1111
Mailing Address - Fax:570-265-7134
Practice Address - Street 1:82 N MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-1914
Practice Address - Country:US
Practice Address - Phone:570-282-0200
Practice Address - Fax:270-282-2229
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist