Healthcare Provider Details

I. General information

NPI: 1942581483
Provider Name (Legal Business Name): KRISTI PATRICIA HOWARD D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. KRISTI PATRICIA FLUEGGE

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5028 ANN ARBOR RD.
JACKSON MI
49201-9201
US

IV. Provider business mailing address

5014 S LAKE DR
CHELSEA MI
48118-9481
US

V. Phone/Fax

Practice location:
  • Phone: 517-879-1505
  • Fax:
Mailing address:
  • Phone: 989-798-0241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501015691
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: