Provider Demographics
NPI:1568585586
Name:KERTON, KERSTEN MARIE (PT, MSR)
Entity Type:Individual
Prefix:MRS
First Name:KERSTEN
Middle Name:MARIE
Last Name:KERTON
Suffix:
Gender:F
Credentials:PT, MSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1976 JEWEL ST
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455
Mailing Address - Country:US
Mailing Address - Phone:843-559-3125
Mailing Address - Fax:
Practice Address - Street 1:1941 SAVAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4704
Practice Address - Country:US
Practice Address - Phone:843-571-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist