Provider Demographics
NPI:1407167984
Name:KEPPEL, SUNG-AH KIM
Entity Type:Individual
Prefix:DR
First Name:SUNG-AH
Middle Name:KIM
Last Name:KEPPEL
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 1:2535 KING LEAR DR
Mailing Address - Street 2:APT #6
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3449
Mailing Address - Country:US
Mailing Address - Phone:412-651-1547
Mailing Address - Fax:
Practice Address - Street 1:3053 NEW GERMANY RD
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-3516
Practice Address - Country:US
Practice Address - Phone:814-472-1100
Practice Address - Fax:814-472-1105
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist