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General NPI Number Information
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NPI Number | 1215843453
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Entity Type | Individual
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Provider Name | MARIAH MARIE KITTRELL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 10215 BROADWAY
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City | CROWN POINT
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State | IN
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Zip | 46307-8001
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Country | US
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Telephone | 219-661-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 2918 MERE DR
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City | COLUMBIA
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State | TN
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Zip | 38401-5146
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Country | US
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Telephone | 931-982-5216
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 17438
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License Number State | TN
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