MEDICARE: KAELA CHRISTAKOS 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1124716626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAELA CHRISTAKOS PT

Provider Business Mailing Address
First Line	:	3832 E HILLERY DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-5260
Country	:	US
Telephone Number	:	507-360-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	3832 E HILLERY DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-5260
Country	:	US
Telephone Number	:	507-360-7575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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Directions to “ KAELA CHRISTAKOS PT” Practice Location

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