Basic Information
| Provider Information | |||||||||
| NPI: | 1619492238 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUZMINSKI | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 DOCK HILL RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178428910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708372123 | ||||||||
| FaxNumber: | 5708372185 | ||||||||
| Practice Location | |||||||||
| Address1: | 318 NEW BLOOMFIELD RD | ||||||||
| Address2: | |||||||||
| City: | DUNCANNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170209503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178343784 | ||||||||
| FaxNumber: | 7178343788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2017 | ||||||||
| LastUpdateDate: | 03/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT026367 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.