Provider Demographics
NPI:1487220372
Name:SELL, KAITLYN ANN (PTA, ATC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ANN
Last Name:SELL
Suffix:
Gender:F
Credentials:PTA, ATC
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ANN
Other - Last Name:BECKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 ALLEGHENY ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1871
Mailing Address - Country:US
Mailing Address - Phone:814-317-5270
Mailing Address - Fax:814-317-5842
Practice Address - Street 1:225 ALLEGHENY ST STE 103
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1871
Practice Address - Country:US
Practice Address - Phone:814-317-5270
Practice Address - Fax:814-317-5842
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE011286225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant