Provider Demographics
NPI:1780183111
Name:KRAUSE, KRISTEN A (DPT)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:A
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OAK GROVE RD.
Mailing Address - Street 2:STE. 3
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-1226
Mailing Address - Country:US
Mailing Address - Phone:570-345-9966
Mailing Address - Fax:570-345-9988
Practice Address - Street 1:8 OAK GROVE RD.
Practice Address - Street 2:STE. 3
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-1226
Practice Address - Country:US
Practice Address - Phone:570-345-9966
Practice Address - Fax:570-345-9988
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist