Doctor Name: | MS. KRISTA GAIL MEMOLY |
NPI Number: | 1134476377 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT |
License Number: | 40QA01451800 |
Business Practice Address: | 425 N Main St Prineville, OR - 977541855 |
Business Phone Number: | 5414167476 |
Business Fax Number: | 5414167478 |
Mailing Address: | 805 Sw Industrial Way, Ste 3 BEND |
State: | OR |
Postal Code: | 977021093 |
Phone Number: | 5415852541 |
Fax Number: | 5415852536 |
NPI Enumeration Date: | 08/07/2012 |
NPI Last Update Date: | 02/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 40QA01451800 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
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 |