Provider Demographics
NPI:1306917711
Name:POWERS, KRISTIN S (ND,LMT)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:S
Last Name:POWERS
Suffix:
Gender:F
Credentials:ND,LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 SW 3RD ST
Mailing Address - Street 2:STE 4
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2400
Mailing Address - Country:US
Mailing Address - Phone:515-964-4771
Mailing Address - Fax:
Practice Address - Street 1:1932 SW 3RD ST
Practice Address - Street 2:STE 4
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2400
Practice Address - Country:US
Practice Address - Phone:515-964-4771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00266225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist