Individual
KRISTINA K W GANTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1034 LAWRENCE ST, EUGENE, OR 97401-3440
(541) 284-2084
(541) 485-1087
Mailing address
PO BOX 5541, EUGENE, OR 97405-0541
(541) 284-2084
(541) 485-1087
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1862
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000135
—
OR
01
—
158091
PTAN
OR
Enumeration date
12/20/2005
Last updated
09/23/2023
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