Provider Demographics
NPI:1912154691
Name:RUPRECHT, KRISTA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MARIE
Last Name:RUPRECHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KRISTA
Other - Middle Name:MARIE
Other - Last Name:REINOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:249 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2368
Mailing Address - Country:US
Mailing Address - Phone:609-607-0555
Mailing Address - Fax:
Practice Address - Street 1:249 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-2368
Practice Address - Country:US
Practice Address - Phone:609-607-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00443600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist