Provider Demographics
NPI:1255734513
Name:HIRSCH, KRISTEN (ATC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 DOVER HILLS DR
Mailing Address - Street 2:APT 205
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1458
Mailing Address - Country:US
Mailing Address - Phone:989-912-8051
Mailing Address - Fax:
Practice Address - Street 1:4711 DOVER HILLS DR
Practice Address - Street 2:APT 205
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1458
Practice Address - Country:US
Practice Address - Phone:989-912-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer