Provider Demographics
NPI:1306380969
Name:AMRANI, KRISTINA ALI (ATC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ALI
Last Name:AMRANI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 COLUMBUS AVE
Mailing Address - Street 2:APT A
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701-1026
Mailing Address - Country:US
Mailing Address - Phone:254-405-0200
Mailing Address - Fax:
Practice Address - Street 1:1500 S UNIVERSITY PARKS DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-1731
Practice Address - Country:US
Practice Address - Phone:254-405-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT57022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer