Healthcare Provider Details

I. General information

NPI: 1518157338
Provider Name (Legal Business Name): SUSAN KERN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 S MAIN ST
RICHLANDTOWN PA
18955-1048
US

IV. Provider business mailing address

2370 ALLENTOWN RD
QUAKERTOWN PA
18951-2120
US

V. Phone/Fax

Practice location:
  • Phone: 267-371-4573
  • Fax:
Mailing address:
  • Phone: 215-536-4163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT005623L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: