Healthcare Provider Details

I. General information

NPI: 1346493467
Provider Name (Legal Business Name): KRISTI L. WHITE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 GOOD SAMARITAN DR SUITE A
CINCINNATI OH
45247-5207
US

IV. Provider business mailing address

4701 CREEK RD SUITE 110
CINCINNATI OH
45242-8398
US

V. Phone/Fax

Practice location:
  • Phone: 513-245-5434
  • Fax: 513-245-5424
Mailing address:
  • Phone: 513-354-2916
  • Fax: 513-588-2429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.003111
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.013232
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: