Provider Demographics
NPI:1487109898
Name:CRAKER, KARI ALENE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:ALENE
Last Name:CRAKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ALENE
Other - Last Name:DIEFFENDERFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:455 PHILIP BLVD
Practice Address - Street 2:BLDG 100-160
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:678-985-0238
Practice Address - Fax:678-985-0136
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012515225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist