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NPI Code Detail

MEDICARE: MISS CRYSTAL LYNN KRITIKOS PT, DPT

MEDICARE: MISS CRYSTAL LYNN KRITIKOS PT, DPT
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 TherapistPT010681GA

General Provider Information

NPI Number : 1639424138
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CRYSTAL LYNN KRITIKOS PT, DPT
Provider Business Mailing Address
First Line : 815 ATLANTA RD
Second Line :
City : CUMMING
State : GA
Zip : 30040-2707
Country : US
Telephone Number : 678-947-0952
Fax Number : 678-947-3579
Provider Business Practice Location Address
First Line : 815 ATLANTA RD
Second Line :
City : CUMMING
State : GA
Zip : 30040-2707
Country : US
Telephone Number : 678-947-0952
Fax Number : 678-947-3579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2012
Last Update Date : 02/25/2015

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Directions to “ MISS CRYSTAL LYNN KRITIKOS PT, DPT” Practice Location

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