Provider Demographics
NPI:1093878357
Name:KENNEDY, KARIN (PT, ATC)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 S BRYN MAWR AVE
Mailing Address - Street 2:COUNTRY DAY SCHOOL OF THE SACRED HEART
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2101
Mailing Address - Country:US
Mailing Address - Phone:610-527-3915
Mailing Address - Fax:
Practice Address - Street 1:480 S BRYN MAWR AVE
Practice Address - Street 2:COUNTRY DAY SCHOOL OF THE SACRED HEART
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2101
Practice Address - Country:US
Practice Address - Phone:610-527-3915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001383A2255A2300X
PADAPT0017472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic