Provider Demographics
NPI:1427033430
Name:CAMPBELL, KRISTEN D (PT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:D
Last Name:CAMPBELL
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 1:208 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2123
Mailing Address - Country:US
Mailing Address - Phone:724-477-5537
Mailing Address - Fax:
Practice Address - Street 1:250A BUTLER CMNS
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2485
Practice Address - Country:US
Practice Address - Phone:724-282-6500
Practice Address - Fax:724-282-4222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013842225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist