Provider Demographics
NPI:1831590959
Name:HERRMANN, KRISTIN W (MPT)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:W
Last Name:HERRMANN
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 1:254 ROYAL RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-9765
Mailing Address - Country:US
Mailing Address - Phone:717-832-2980
Mailing Address - Fax:
Practice Address - Street 1:254 ROYAL RD
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-9765
Practice Address - Country:US
Practice Address - Phone:717-832-2980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007882L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist