Provider Demographics
NPI:1366013674
Name:KURO, JACLYN RUTH
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:RUTH
Last Name:KURO
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 1:12 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1640
Mailing Address - Country:US
Mailing Address - Phone:717-368-8983
Mailing Address - Fax:
Practice Address - Street 1:7 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:PA
Practice Address - Zip Code:19363-1354
Practice Address - Country:US
Practice Address - Phone:610-467-9981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010065224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant