Provider Demographics
NPI:1013659812
Name:KB PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:KB PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:412-398-0574
Mailing Address - Street 1:1117 REDOAK DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15636-1601
Mailing Address - Country:US
Mailing Address - Phone:412-398-0574
Mailing Address - Fax:
Practice Address - Street 1:3907 OLD WILLIAM PENN HWY STE 304
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1834
Practice Address - Country:US
Practice Address - Phone:412-398-0574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty