Individual
MRS. KRISTA ROSE BRANDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MS
Contact information
Practice address
411 BERTHA WALLACE DR, IRVINE, KY 40336-9418
(606) 723-5153
Mailing address
114 ANN ST, IRVINE, KY 40336-1066
(606) 723-5153
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004139
KY
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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