Provider Demographics
NPI:1770207896
Name:RIZER, KRISTIN MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:RIZER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14110 JADE MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-8051
Mailing Address - Country:US
Mailing Address - Phone:325-518-4763
Mailing Address - Fax:
Practice Address - Street 1:1129 MECHEM DR STE C
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-7292
Practice Address - Country:US
Practice Address - Phone:575-808-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT22002225100000X
AZCP015279T225100000X
TX1363989225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty