Individual
MRS. KRISTEN MATTHEWS FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3234 CAHABA HEIGHTS RD, VESTAVIA, AL 35243
(205) 298-9101
(205) 298-9103
Mailing address
3234 CAHABA HEIGHTS RD, VESTAVIA, AL 35243-1614
(205) 298-9101
(205) 298-9103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH4951
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11710217
CAQH
—
01
—
51108092
BCBS OF AL
AL
Enumeration date
01/11/2007
Last updated
06/11/2018
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