Provider Demographics
NPI:1710338009
Name:DEHART, KRISTIN (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:DEHART
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 1:2124 LAUREL GLEN DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3434
Mailing Address - Country:US
Mailing Address - Phone:717-315-6351
Mailing Address - Fax:
Practice Address - Street 1:290 E POMFRET ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2579
Practice Address - Country:US
Practice Address - Phone:717-245-0400
Practice Address - Fax:717-243-5688
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT025208OtherLICENSE