Provider Demographics
NPI:1720041999
Name:KRIMMEL, AILEEN N (MSPT)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:N
Last Name:KRIMMEL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:AILEEN
Other - Middle Name:N
Other - Last Name:KRESGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 WOODLAND TER
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-7010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4310
Practice Address - Country:US
Practice Address - Phone:814-949-9500
Practice Address - Fax:814-949-9550
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077669R9XMedicare Oscar/Certification