Provider Demographics
NPI:1619471653
Name:KREYMER, ELIZABETH KLARA (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KLARA
Last Name:KREYMER
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:KREYMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1348 SW 2ND CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7593
Mailing Address - Country:US
Mailing Address - Phone:954-562-1333
Mailing Address - Fax:
Practice Address - Street 1:1021 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3321
Practice Address - Country:US
Practice Address - Phone:954-835-5619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist