Provider Demographics
NPI:1285678797
Name:KUNKEL, SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:KUNKEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:PA
Mailing Address - Zip Code:17547-9229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 EVELYN DR
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17061-1258
Practice Address - Country:US
Practice Address - Phone:717-692-4708
Practice Address - Fax:717-692-5464
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016772225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist