Provider Demographics
NPI:1730375825
Name:STRADT, KRISTEN MURGA (DPT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MURGA
Last Name:STRADT
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 1:6565 W MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9144
Mailing Address - Country:US
Mailing Address - Phone:269-372-1027
Mailing Address - Fax:269-372-2940
Practice Address - Street 1:6565 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9144
Practice Address - Country:US
Practice Address - Phone:269-372-1027
Practice Address - Fax:269-372-2940
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist