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General NPI Number Information
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NPI Number | 1255221933
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Entity Type | Individual
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Provider Name | KERRY MAUREEN ODONNELL DURST PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/05/2025
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 1800 LOMBARD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1414
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Country | US
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Telephone | 215-620-3251
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHRISTIAN ST UNIT 15
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City | PHILADELPHIA
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State | PA
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Zip | 19147-4346
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Country | US
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Telephone | 215-620-3251
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT017368
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License Number State | PA
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