Doctor Name: | KRISTIN ERIN DEATHERAGE |
NPI Number: | 1649509621 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT MPT |
License Number: | PT871020 |
Business Practice Address: | 9892 Constitution Dr Huntington Beach, CA - 926463649 |
Business Phone Number: | 7146541110 |
Business Fax Number: | |
Mailing Address: | 9892 Constitution Dr, HUNTINGTON BEACH |
State: | CA |
Postal Code: | 926463649 |
Phone Number: | 7146541110 |
Fax Number: | |
NPI Enumeration Date: | 12/21/2009 |
NPI Last Update Date: | 12/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT871020 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | DC |
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 |