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General NPI Number Information
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NPI Number | 1083228746
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Entity Type | Individual
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Provider Name | KIRSTEN BROOKE RAYNER PT
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Gender | Female
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 10/20/2024
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Provider Practice Location Address
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Address Line | 340 COMMERCE AVE STE 15
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-7168
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Country | US
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Telephone | 910-637-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 ROCK MERRITT AVE
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City | FORT BRAGG
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State | NC
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Zip | 28310-1000
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Country | US
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Telephone | 109-078-9229
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Fax | 910-907-6069
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P19903
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License Number State | NC
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