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NPI Code Detail

MEDICARE: KRISTIN DOLL PT

MEDICARE: KRISTIN DOLL PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist008677OH

General Provider Information

NPI Number : 1023477783
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN DOLL PT
Provider Business Mailing Address
First Line : 713 W AUGLAIZE ST
Second Line :
City : WAPAKONETA
State : OH
Zip : 45895-1302
Country : US
Telephone Number : 567-356-6003
Fax Number :
Provider Business Practice Location Address
First Line : 2535 FORT AMANDA RD
Second Line :
City : LIMA
State : OH
Zip : 45804-3728
Country : US
Telephone Number : 419-999-2055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2016
Last Update Date : 02/23/2016

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