Provider Demographics
NPI:1427228733
Name:BIDDLE, KELLY ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ELIZABETH
Last Name:BIDDLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ELIZABETH
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:459 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2547
Mailing Address - Country:US
Mailing Address - Phone:610-388-1866
Mailing Address - Fax:
Practice Address - Street 1:315 E LONDON GROVE RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:PA
Practice Address - Zip Code:19318
Practice Address - Country:US
Practice Address - Phone:610-869-2456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007050L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist