Provider Demographics
NPI:1700548567
Name:SENTZ, KRISTIN (PTA)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:SENTZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:482 DONNET CT
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-8915
Mailing Address - Country:US
Mailing Address - Phone:989-418-0578
Mailing Address - Fax:
Practice Address - Street 1:2532 W CADILLAC DR
Practice Address - Street 2:
Practice Address - City:FARWELL
Practice Address - State:MI
Practice Address - Zip Code:48622-9757
Practice Address - Country:US
Practice Address - Phone:989-588-9928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502006514225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant