Provider Demographics
NPI:1417507542
Name:HOUGH, KERRI M (PT)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:M
Last Name:HOUGH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-541-1974
Mailing Address - Fax:
Practice Address - Street 1:2556 EASTERN BLVD STE 15
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2914
Practice Address - Country:US
Practice Address - Phone:717-900-1743
Practice Address - Fax:717-900-8604
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029416225100000X
DCPT872536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist