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NPI Code Detail

MEDICARE: MRS. KRISTIN POPA P.T.

MEDICARE:  MRS. KRISTIN  POPA  P.T.
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 Therapist2009027343MO

General Provider Information

NPI Number : 1336483775
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIN POPA P.T.
Provider Business Mailing Address
First Line : 1306 GARY ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-2134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3003 FALLING LEAF CT
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-3549
Country : US
Telephone Number : 573-256-4620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2012
Last Update Date : 11/26/2012

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Directions to “ MRS. KRISTIN POPA P.T.” Practice Location

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