Provider Demographics
NPI:1568590933
Name:KERR, JARET BLAINE (MOTRL)
Entity Type:Individual
Prefix:MR
First Name:JARET
Middle Name:BLAINE
Last Name:KERR
Suffix:
Gender:M
Credentials:MOTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:VANDERGRIFT
Mailing Address - State:PA
Mailing Address - Zip Code:15690-1109
Mailing Address - Country:US
Mailing Address - Phone:724-882-4491
Mailing Address - Fax:
Practice Address - Street 1:103 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:VANDERGRIFT
Practice Address - State:PA
Practice Address - Zip Code:15690-1109
Practice Address - Country:US
Practice Address - Phone:724-882-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC-005132L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist