MEDICARE: KRISTI KORANDO PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1157770	TX

General Provider Information

NPI Number	:	1972531069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI KORANDO PT

Provider Business Mailing Address
First Line	:	6001 PHOTINIA AVE
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-6819
Country	:	US
Telephone Number	:	940-382-6308
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 EMPIRE CENTRAL DR
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75247-4027
Country	:	US
Telephone Number	:	214-905-5000
Fax Number	:	214-905-5015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/08/2007

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Directions to “ KRISTI KORANDO PT” Practice Location

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