Provider Demographics
NPI:1629687389
Name:KERECMAN, LINDSEY ANN (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:KERECMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 ELFINWILD LN
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-1451
Mailing Address - Country:US
Mailing Address - Phone:814-450-0783
Mailing Address - Fax:
Practice Address - Street 1:5310 CASTLEWOOD CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2587
Practice Address - Country:US
Practice Address - Phone:814-450-0783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist