Provider Demographics
NPI:1124341904
Name:KRUS HOLMES, CHRISTI ANNE (PT)
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:ANNE
Last Name:KRUS HOLMES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:ANNE
Other - Last Name:KRUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:303 N KEENE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7193
Mailing Address - Country:US
Mailing Address - Phone:573-443-0225
Mailing Address - Fax:573-443-0290
Practice Address - Street 1:777 S NEW BALLAS RD
Practice Address - Street 2:STE 218E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8705
Practice Address - Country:US
Practice Address - Phone:314-991-2562
Practice Address - Fax:314-991-2593
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist