Provider Demographics
NPI:1245639103
Name:KILMER, DEANNA ELIZABETH (KILMER, DEANNA PTA)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:ELIZABETH
Last Name:KILMER
Suffix:
Gender:F
Credentials:KILMER, DEANNA PTA
Other - Prefix:MISS
Other - First Name:DEANNA
Other - Middle Name:ELIZABETH
Other - Last Name:DARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:131 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18433-7761
Mailing Address - Country:US
Mailing Address - Phone:570-877-2127
Mailing Address - Fax:
Practice Address - Street 1:81 STURGES RD
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-1302
Practice Address - Country:US
Practice Address - Phone:570-383-7230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI002320225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant