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NPI Code Detail

MEDICARE: KRISTINE INGULLI COLT P.T.

MEDICARE: KRISTINE INGULLI COLT 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 Therapist5501017361MI

General Provider Information

NPI Number : 1639128663
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE INGULLI COLT P.T.
Provider Business Mailing Address
First Line : 10809 S SAGINAW ST
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-7033
Country : US
Telephone Number : 832-277-3640
Fax Number :
Provider Business Practice Location Address
First Line : 10809 S SAGINAW ST
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-7033
Country : US
Telephone Number : 832-277-3640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 02/14/2016

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Directions to “ KRISTINE INGULLI COLT P.T.” Practice Location

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