Provider Demographics
NPI:1952687402
Name:SENSBACH, KRYSTA ANN (MED, ATC)
Entity Type:Individual
Prefix:
First Name:KRYSTA
Middle Name:ANN
Last Name:SENSBACH
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6452
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-0452
Mailing Address - Country:US
Mailing Address - Phone:609-284-4172
Mailing Address - Fax:
Practice Address - Street 1:11 FAIRLANE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9567
Practice Address - Country:US
Practice Address - Phone:610-779-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTO0000162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer