Doctor Name: | KIRSTEN E AULT |
NPI Number: | 1831366053 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA |
License Number: | 06003508A |
Business Practice Address: | 9418 W County Road 300 S Medora, IN - 472609709 |
Business Phone Number: | 8125210054 |
Business Fax Number: | 8129662407 |
Mailing Address: | 9418 W County Road 300 S, MEDORA |
State: | IN |
Postal Code: | 472609709 |
Phone Number: | 8125210054 |
Fax Number: | 8129662407 |
NPI Enumeration Date: | 05/15/2008 |
NPI Last Update Date: | 05/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 06003508A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |