| Doctor Name: | KRISTEN ALEXANDRIA WIDMAYER |
| NPI Number: | 1124355433 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 12270 |
| Business Practice Address: | 147 Hwy 24 Hestron Plaza, Suite 102 Morehead City, NC - 28557 |
| Business Phone Number: | 2527264000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 158, MOREHEAD CITY |
| State: | NC |
| Postal Code: | 285570158 |
| Phone Number: | 2527264000 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2009 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 12270 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |