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NPI Code Detail

MEDICARE: KRISTINE BRIGGS-CONNELLY MSPT

MEDICARE: KRISTINE BRIGGS-CONNELLY MSPT
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
12251X0800XOrthopedic Physical Therapist05007019AIN

General Provider Information

NPI Number : 1174504278
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE BRIGGS-CONNELLY MSPT
Provider Business Mailing Address
First Line : 3844 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-483-9933
Fax Number : 260-483-9931
Provider Business Practice Location Address
First Line : 3844 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-483-9933
Fax Number : 260-483-9931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 09/17/2013

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Directions to “ KRISTINE BRIGGS-CONNELLY MSPT” Practice Location

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