Kristen Sitzes

Individual provider Active NPI Physical Therapist · Malden, MO

NPI 1104936871 · NPPES record last updated Feb 27, 2015

Key facts

NPI
1104936871
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
906 N Douglass St
Malden, MO 63863-1514
Phone
(573) 276-5860
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

906 N Douglass St
Malden, MO 63863-1514

Mailing address

16022 County Road 612
Dexter, MO 63841-9501
Phone (573) 614-0912

Other identifiers

IdentifierTypeStateIssuer
2004033971OtherMOLICENSE#

Other providers in Malden, MO

All providers in Malden, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.