Provider Demographics
NPI:1811329568
Name:KISSLING, KRISTIN A (DPT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:A
Last Name:KISSLING
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 1:75 EVELYN DR
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17061-1258
Mailing Address - Country:US
Mailing Address - Phone:717-692-4708
Mailing Address - Fax:717-692-4715
Practice Address - Street 1:101 S LIME ST
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-1233
Practice Address - Country:US
Practice Address - Phone:717-786-8053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist