Healthcare Provider Details

I. General information

NPI: 1598842049
Provider Name (Legal Business Name): KRISTIN SIEGFRIED GERRETY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 MERRIMON AVE
ASHEVILLE NC
28804-2405
US

IV. Provider business mailing address

852 MERRIMON AVENUE
ASHEVILLEQ NC
28804-2405
US

V. Phone/Fax

Practice location:
  • Phone: 828-251-6091
  • Fax: 828-251-6911
Mailing address:
  • Phone: 828-251-6091
  • Fax: 828-251-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number011592
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberP14569
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: