Provider Demographics
NPI:1831385475
Name:IRELAND, KATHRYN ANN (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:IRELAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WELSH RD
Mailing Address - Street 2:APT. 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1424
Mailing Address - Country:US
Mailing Address - Phone:513-706-7725
Mailing Address - Fax:
Practice Address - Street 1:159 WATERDAM RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2576
Practice Address - Country:US
Practice Address - Phone:724-942-1511
Practice Address - Fax:724-942-1513
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-018964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist