Provider Demographics
NPI:1134346760
Name:VANCE, KATHRYN MARIE (LPT)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:MARIE
Last Name:VANCE
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 YORK RD FL 1
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3269
Mailing Address - Country:US
Mailing Address - Phone:215-885-2009
Mailing Address - Fax:215-885-2009
Practice Address - Street 1:200 YORK RD FL 1
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3269
Practice Address - Country:US
Practice Address - Phone:215-885-2009
Practice Address - Fax:215-885-2009
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005154L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist