Provider Demographics
NPI:1427130004
Name:PERROTTI FLOYD, KRISTINE M (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:M
Last Name:PERROTTI FLOYD
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4955 N BANK RD
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531
Mailing Address - Country:US
Mailing Address - Phone:707-951-0069
Mailing Address - Fax:
Practice Address - Street 1:614 SPRUCE ST.
Practice Address - Street 2:BROOKINGS HARBOR PHYSICAL THERAPY
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415
Practice Address - Country:US
Practice Address - Phone:541-469-1062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR998171225X00000X
CACA4960225X00000X
NYNY0067761225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist