Individual
KRISTIN WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4120 WOODED ACRE LN, LOUISVILLE, KY 40245-2938
(502) 691-7131
Mailing address
4120 WOODED ACRE LN, LOUISVILLE, KY 40245-2938
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02746
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A02746
KENTUCKY BOARD OF PHYSICAL THERAPY
KY
Enumeration date
04/19/2020
Last updated
04/19/2020
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