Provider Demographics
NPI:1023164290
Name:ROHRER, KRISTEN LYLE (MPT)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LYLE
Last Name:ROHRER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:92 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1499
Mailing Address - Country:US
Mailing Address - Phone:413-584-7971
Mailing Address - Fax:413-584-1179
Practice Address - Street 1:92 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1499
Practice Address - Country:US
Practice Address - Phone:413-584-7971
Practice Address - Fax:413-584-1179
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117592251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAROY68446Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER