Provider Demographics
NPI:1184057770
Name:HARRISON, KAITLIN M (PT)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:M
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 TRICH DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5990
Mailing Address - Country:US
Mailing Address - Phone:724-225-8657
Mailing Address - Fax:724-228-8388
Practice Address - Street 1:5000 WATERDAM PLAZA DR
Practice Address - Street 2:SUITE 240
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-5412
Practice Address - Country:US
Practice Address - Phone:724-941-0111
Practice Address - Fax:724-941-9231
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist