Provider Demographics
NPI:1437512019
Name:YURKOVIC, KRISTINE ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:ELIZABETH
Last Name:YURKOVIC
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 1:4915 MCCLELLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16510-4037
Mailing Address - Country:US
Mailing Address - Phone:814-490-6456
Mailing Address - Fax:
Practice Address - Street 1:4915 MCCLELLAND AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-4037
Practice Address - Country:US
Practice Address - Phone:814-490-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist