Provider Demographics
NPI:1265127229
Name:NORDIN, KALI CHRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:CHRISTINE
Last Name:NORDIN
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 1:3623 CROSSINGS DR STE 282
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7101
Mailing Address - Country:US
Mailing Address - Phone:602-570-8702
Mailing Address - Fax:
Practice Address - Street 1:3623 CROSSINGS DR STE 282
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:602-570-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-0130632251C2600X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist