Provider Demographics
NPI:1154358877
Name:LANTZ, KRISTIN CARDIN (MS, ATC)
Entity type:Individual
Prefix:MR
First Name:KRISTIN
Middle Name:CARDIN
Last Name:LANTZ
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14390 WATERWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:FORTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46040-9456
Mailing Address - Country:US
Mailing Address - Phone:317-482-0030
Mailing Address - Fax:
Practice Address - Street 1:14390 WATERWAY BLVD
Practice Address - Street 2:
Practice Address - City:FORTVILLE
Practice Address - State:IN
Practice Address - Zip Code:46040-9456
Practice Address - Country:US
Practice Address - Phone:317-482-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer