Provider Demographics
NPI:1063633253
Name:CRUSE, KRISTEN ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ANN
Last Name:CRUSE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:STRONGSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15957
Mailing Address - Country:US
Mailing Address - Phone:814-341-9990
Mailing Address - Fax:
Practice Address - Street 1:535 MCFARLAND RD
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650
Practice Address - Country:US
Practice Address - Phone:724-537-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE007654225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant