Provider Demographics
NPI:1306391230
Name:PERRY, DAVID KENT (OTR/L)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KENT
Last Name:PERRY
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BILLS WAY
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-1033
Mailing Address - Country:US
Mailing Address - Phone:302-388-4574
Mailing Address - Fax:610-255-4202
Practice Address - Street 1:9 BILLS WAY
Practice Address - Street 2:
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-1033
Practice Address - Country:US
Practice Address - Phone:302-388-4574
Practice Address - Fax:610-255-4202
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-21
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0000954225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist