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General NPI Number Information
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NPI Number | 1407312473
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Entity Type | Individual
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Provider Name | KRISTINA MARIE WNUK PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 559 W TWINCOURT TRL UNIT 610
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City | ST AUGUSTINE
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State | FL
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Zip | 32095-8805
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Country | US
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Telephone | 904-671-0255
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Fax |
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Provider Business Mailing Address
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Address Line | 174 ARDILA CIR
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-0219
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Country | US
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Telephone | 732-822-4067
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT014345
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT35654
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License Number State | FL
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