Provider Demographics
NPI:1285083899
Name:SWATFAGER, KRISTINA (DPT, PT)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SWATFAGER
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 28TH ST
Mailing Address - Street 2:MAIL ROUTE 12210
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3723
Mailing Address - Country:US
Mailing Address - Phone:612-863-1924
Mailing Address - Fax:612-863-2758
Practice Address - Street 1:800 E 28TH ST
Practice Address - Street 2:MAIL ROUTE 12210
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-863-1924
Practice Address - Fax:612-863-2758
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN93502251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology