Provider Demographics
NPI:1871974097
Name:HENRY, KRISTIN (DPT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HUDSON RD STE A
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2304
Mailing Address - Country:US
Mailing Address - Phone:319-277-5616
Mailing Address - Fax:319-277-0355
Practice Address - Street 1:1001 HUDSON RD STE A
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2304
Practice Address - Country:US
Practice Address - Phone:319-277-5616
Practice Address - Fax:319-277-0355
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078219225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist