MEDICARE: KERRY DUFFY JOYCE MSPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT015342	PA

General Provider Information

NPI Number	:	1134213267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRY DUFFY JOYCE MSPT

Provider Business Mailing Address
First Line	:	539 S STATE ST
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-1557
Country	:	US
Telephone Number	:	570-586-4186
Fax Number	:	570-587-1058

Provider Business Practice Location Address
First Line	:	539 S STATE ST
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-1557
Country	:	US
Telephone Number	:	570-586-4186
Fax Number	:	570-587-1058

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	04/06/2015

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