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General NPI Number Information
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NPI Number | 1407421159
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Entity Type | Individual
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Provider Name | KRISTEN STUCKY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 800 N JUSTICE ST
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3410
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Country | US
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Telephone | 828-696-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 19 TIGER LILY LN LOT 13
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City | MILLS RIVER
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State | NC
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Zip | 28759-0082
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Country | US
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Telephone | 612-345-1950
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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 | 1336185
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License Number State | TX
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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 | P19931
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License Number State | NC
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