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Individual

MS. KRISTINA LOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
4440 N 36TH ST, 240, PHOENIX, AZ 85018-3588
(602) 956-4040
(602) 956-4011
Mailing address
4440 N 36TH ST, 240, PHOENIX, AZ 85018-3588
(602) 956-4040
(602) 956-4011

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6024
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120355
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
AZ
01
852675
AHCCCS ID#
AZ
01
AZ0294160
BCBS OF AZ PROVIDER ID#
AZ
Enumeration date
11/17/2006
Last updated
04/27/2016
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