Provider Demographics
NPI:1194958116
Name:GARNER, KRIS KATHERINE (KRIS GARNER)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:KATHERINE
Last Name:GARNER
Suffix:
Gender:F
Credentials:KRIS GARNER
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:KATHERINE
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMT
Mailing Address - Street 1:208 13TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-4598
Mailing Address - Country:US
Mailing Address - Phone:651-329-8296
Mailing Address - Fax:
Practice Address - Street 1:208 13 AVE. NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-5540
Practice Address - Country:US
Practice Address - Phone:651-329-8296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist