Individual
KRISTY RECEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20658
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144336
OPTIMUM CHOICE
MD
01
—
350342400
OWCP
MD
01
—
4846270001
DME POS
MD
01
—
51647
TRICARE, EHP, PRIORITY PA
MD
01
—
522248150
IHP, COVENTRY, UNITED HC
MD
01
—
PENDING
BCBS
MD
05
—
PENDING
—
MD
Enumeration date
06/04/2006
Last updated
07/10/2007
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