Provider Demographics
NPI:1578003877
Name:MENNITTO, KRISTI REY (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:REY
Last Name:MENNITTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4726
Mailing Address - Country:US
Mailing Address - Phone:717-652-5050
Mailing Address - Fax:
Practice Address - Street 1:648 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1513
Practice Address - Country:US
Practice Address - Phone:717-867-4000
Practice Address - Fax:717-867-2177
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor