Provider Demographics
NPI:1295513034
Name:SPALDING, KRISTA NATASHA (PTA)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:NATASHA
Last Name:SPALDING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:NATASHA
Other - Last Name:STAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1414 WESTBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5026
Mailing Address - Country:US
Mailing Address - Phone:817-304-9956
Mailing Address - Fax:
Practice Address - Street 1:260 WILLOW BEND DR STE 200
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-1276
Practice Address - Country:US
Practice Address - Phone:817-441-2555
Practice Address - Fax:817-441-2556
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant