Provider Demographics
NPI:1558248062
Name:O'CONNOR, KRISTEN (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 BLALOCK RD SE
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-4209
Mailing Address - Country:US
Mailing Address - Phone:586-770-3620
Mailing Address - Fax:
Practice Address - Street 1:431 HIGHWAY 53 E STE 250
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-3058
Practice Address - Country:US
Practice Address - Phone:706-403-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist