Provider Demographics
NPI:1538250048
Name:SARTORE, KRISTIN M (DPT)
Entity type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:M
Last Name:SARTORE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6200
Mailing Address - Fax:520-784-6109
Practice Address - Street 1:6320 N. LA CHOLLA BLVD. #200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3549
Practice Address - Country:US
Practice Address - Phone:520-382-8200
Practice Address - Fax:520-397-3505
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005618225100000X
IN05009095A225100000X
AZ10033225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000627943OtherBLUE CROSS BLUE SHIELD
IN000000519680OtherBLUE CROSS BLUE SHIELD
IN000000627943OtherBLUE CROSS BLUE SHIELD
INP00618888Medicare UPIN
IN216070SMedicare PIN