Individual
KIRSTEN ATCHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
12722 TONKEL RD STE 102, FORT WAYNE, IN 46845-8201
(269) 739-0300
Mailing address
428 CEDAR GLEN DR APT 1, FORT WAYNE, IN 46825-6212
(260) 241-8932
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013346A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05013346A
LICENSE
IN
05
—
300032651
—
IN
Enumeration date
06/03/2019
Last updated
04/07/2021
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