Provider Demographics
NPI:1548205628
Name:HOHN, KELLY M (PT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:M
Last Name:HOHN
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 1:125 N FRANKLIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4307
Mailing Address - Country:US
Mailing Address - Phone:724-223-1207
Mailing Address - Fax:724-223-1209
Practice Address - Street 1:125 N FRANKLIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4307
Practice Address - Country:US
Practice Address - Phone:724-223-1207
Practice Address - Fax:724-223-1209
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013756L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015935850017Medicaid
PA251570641OtherTAX ID
PA0015935850017Medicaid