Provider Demographics
NPI:1184964652
Name:DELACRUZ, KRISTA JEAN (MPT)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:JEAN
Last Name:DELACRUZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 KNOXLYN ORRTANNA RD
Mailing Address - Street 2:
Mailing Address - City:ORRTANNA
Mailing Address - State:PA
Mailing Address - Zip Code:17353-9345
Mailing Address - Country:US
Mailing Address - Phone:301-806-6984
Mailing Address - Fax:
Practice Address - Street 1:1575 KNOXLYN ORRTANNA RD
Practice Address - Street 2:
Practice Address - City:ORRTANNA
Practice Address - State:PA
Practice Address - Zip Code:17353-9345
Practice Address - Country:US
Practice Address - Phone:301-806-6984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011893L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist