Mortensen, Kristen Rayburn

Mortensen, Kristen Rayburn is an individual health care provider with primary practice located at 1310 Garlington Rd Ste A Suite A, Greenville SC 29615-5485. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Mortensen, Kristen Rayburn can be contacted via phone (864) 288-2998.

Contact Information

Primary practice address
1310 Garlington Rd Ste A Suite A Greenville SC 29615-5485
Phone: (864) 288-2998
Fax: (864) 288-3522
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4405 South Carolina

Profile Details

NPI number 1780644310
LBN Legal business name Mortensen, Kristen Rayburn
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Apr 22nd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780644310 NPPES
South Carolina MEDICAID TH1496

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