Individual
KRISTA AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7484 INDIAN RD, TEMPERANCE, MI 48182-1513
(419) 509-1276
Mailing address
7484 INDIAN RD, TEMPERANCE, MI 48182-1513
(419) 509-1276
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
07542
OH
225200000X
Physical Therapy Assistant
5502002862
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07542
PHYSICAL THERAPIST ASSISTANT
OH
Enumeration date
09/16/2014
Last updated
09/16/2014
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