Provider Demographics
NPI:1598968745
Name:KROUSE, COLLEEN L (MPT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:L
Last Name:KROUSE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 JAMISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-2590
Mailing Address - Country:US
Mailing Address - Phone:724-758-7044
Mailing Address - Fax:724-758-3126
Practice Address - Street 1:104 PAPPAN BUSINESS DR
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1261
Practice Address - Country:US
Practice Address - Phone:724-530-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-013282-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist