Individual
MR. KRISTOPHER D ISENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 GERALO LANE, LYNN HAVEN, FL 32444
(850) 819-4981
Mailing address
11500 MADDIE AVE, FORT WORTH, TX 76244-7583
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2088680
TX
225200000X
Physical Therapy Assistant
PTA21973
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871849836
—
TX
Enumeration date
07/27/2012
Last updated
08/28/2018
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