Doctor Name: | MICHELLE DESJARLAIS KISTLER |
NPI Number: | 1619204450 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 1922 |
Business Practice Address: | 987 Siskiyou Blvd Ashland, OR - 975202237 |
Business Phone Number: | 5414820625 |
Business Fax Number: | |
Mailing Address: | 557 N Mountain Ave, ASHLAND |
State: | OR |
Postal Code: | 975209658 |
Phone Number: | 5412928505 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2009 |
NPI Last Update Date: | 11/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1922 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
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 |