Healthcare Provider Details

I. General information

NPI: 1265052815
Provider Name (Legal Business Name): KRISTEN M MARKLE LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN M SCHMIDT

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796 MILL RD
SPRING GROVE PA
17362-9183
US

IV. Provider business mailing address

796 MILL RD
SPRING GROVE PA
17362-9183
US

V. Phone/Fax

Practice location:
  • Phone: 717-965-2026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberTEI004159
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI004159
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: