Provider Demographics
NPI:1588113807
Name:PIFER, KRISTIN (PT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:PIFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 N NAVAJO DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-8663
Mailing Address - Country:US
Mailing Address - Phone:928-771-9327
Mailing Address - Fax:
Practice Address - Street 1:3050 N NAVAJO DR
Practice Address - Street 2:SUITE 110
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-8663
Practice Address - Country:US
Practice Address - Phone:928-771-9327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist