MEDICARE: KRISTEN ROARK DPT

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	374J00000X	Doula	2461	DE
2	225100000X	Physical Therapist	J1-0003208	DE

General Provider Information

NPI Number	:	1447659180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN ROARK DPT

Provider Business Mailing Address
First Line	:	26193 RICH FIELD DR
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-6881
Country	:	US
Telephone Number	:	862-266-6069
Fax Number	:

Provider Business Practice Location Address
First Line	:	17425 OCEAN ONE PLZ UNIT 4
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-1924
Country	:	US
Telephone Number	:	302-703-0213
Fax Number	:

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

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	03/12/2026

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Directions to “ KRISTEN ROARK DPT” Practice Location

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