Individual
MS. KRISTA MALINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10300 W 103RD ST STE 300, OVERLAND PARK, KS 66214-2658
(913) 894-1910
Mailing address
7036 METCALF AVE, OVERLAND PARK, KS 66204-1353
(913) 677-1267
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
00789
IA
225200000X
Physical Therapy Assistant
Primary
14-01730
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00789
STATE LICENSE
IA
01
—
14-01730
STATE LICENSE
KS
Enumeration date
05/01/2007
Last updated
07/08/2007
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