Provider Demographics
NPI:1588861132
Name:FOX, KRISTIN K (PT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:K
Last Name:FOX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:K
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:411 SE 10TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-3571
Mailing Address - Country:US
Mailing Address - Phone:605-556-0175
Mailing Address - Fax:605-556-0175
Practice Address - Street 1:411 SE 10TH ST STE 103
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-3571
Practice Address - Country:US
Practice Address - Phone:605-201-0784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist