Healthcare Provider Details

I. General information

NPI: 1053220277
Provider Name (Legal Business Name): KRISTINA NARRAGON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 QUARTER ST
GLADWIN MI
48624-1941
US

IV. Provider business mailing address

210 W STAR RD
SANFORD MI
48657-9595
US

V. Phone/Fax

Practice location:
  • Phone: 989-294-4093
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502001680
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: