Provider Demographics
NPI:1326790775
Name:TIMALONIS, KATHLEEN RENEE
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RENEE
Last Name:TIMALONIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 N RONKS RD
Mailing Address - Street 2:
Mailing Address - City:RONKS
Mailing Address - State:PA
Mailing Address - Zip Code:17572-9611
Mailing Address - Country:US
Mailing Address - Phone:412-218-5959
Mailing Address - Fax:
Practice Address - Street 1:2100 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG011628225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist