Provider Demographics
NPI:1023661469
Name:MCELWEE, KATHLEEN
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MCELWEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:MCALLISTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:KATHLEEN MCALLISTER
Mailing Address - Street 1:2855 OLD CEDAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-1041
Mailing Address - Country:US
Mailing Address - Phone:610-308-4846
Mailing Address - Fax:
Practice Address - Street 1:2855 OLD CEDAR GROVE RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-1041
Practice Address - Country:US
Practice Address - Phone:610-308-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer