Doctor Name: | MRS. KRISTEN RUBY GLASS |
NPI Number: | 1205103181 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT |
License Number: | 1207617 |
Business Practice Address: | 4848 Ne Stallings Dr Nacogdoches, TX - 759651239 |
Business Phone Number: | 9365601618 |
Business Fax Number: | |
Mailing Address: | 4848 Ne Stallings Dr, Suite 201 NACOGDOCHES |
State: | TX |
Postal Code: | 759651239 |
Phone Number: | 9365601618 |
Fax Number: | 9365603554 |
NPI Enumeration Date: | 11/21/2011 |
NPI Last Update Date: | 11/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1207617 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |