Provider Demographics
NPI:1952484867
Name:KLAMORICK-VITEK, DANITA KAY (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:DANITA
Middle Name:KAY
Last Name:KLAMORICK-VITEK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 OLD WILLIAM PENN HIGHWAY STE 3
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1725
Mailing Address - Country:US
Mailing Address - Phone:724-387-1007
Mailing Address - Fax:724-387-1009
Practice Address - Street 1:3700 OLD WILLIAM PENN HWY STE 3
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1861
Practice Address - Country:US
Practice Address - Phone:724-387-1007
Practice Address - Fax:724-387-1009
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002868E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA374829OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA374829OtherHIGHMARK BLUE CROSS BLUE SHIELD