Basic Information
Provider Information
NPI: 1649817305
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ERWIN
FirstName: KATHRYN
MiddleName: OLIVIA
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8205 PRESIDENTS DR
Address2:  
City: HUMMELSTOWN
State: PA
PostalCode: 170368621
CountryCode: US
TelephoneNumber: 7178392159
FaxNumber: 7175651104
Practice Location
Address1: 3102 RAINBOW DR STE 200
Address2:  
City: RAINBOW CITY
State: AL
PostalCode: 359065804
CountryCode: US
TelephoneNumber: 2565496387
FaxNumber: 2565496391
Other Information
ProviderEnumerationDate: 12/02/2019
LastUpdateDate: 12/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH9641ALY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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