Healthcare Provider Details

I. General information

NPI: 1235209917
Provider Name (Legal Business Name): SUSAN M KREINBROOK MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 PITTSBURGH ST
CHESWICK PA
15024-1447
US

IV. Provider business mailing address

1214 CARLISLE ST
NATRONA HEIGHTS PA
15065-1020
US

V. Phone/Fax

Practice location:
  • Phone: 724-274-4333
  • Fax: 724-274-4303
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016590
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: