Provider Demographics
NPI:1548318074
Name:TOTTORI, KRIS ANN (PT)
Entity type:Individual
Prefix:MS
First Name:KRIS
Middle Name:ANN
Last Name:TOTTORI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6142
Mailing Address - Country:US
Mailing Address - Phone:972-741-3666
Mailing Address - Fax:
Practice Address - Street 1:9204 T N SKILES RD
Practice Address - Street 2:
Practice Address - City:PONDER
Practice Address - State:TX
Practice Address - Zip Code:76259-5819
Practice Address - Country:US
Practice Address - Phone:940-479-2612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist