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NPI Code Detail

MEDICARE: MARY M KRELL PT

MEDICARE: MARY M KRELL PT
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
1225100000XPhysical Therapist070-019396IL
2225100000XPhysical Therapist33713FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457609687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY M KRELL PT
Provider Business Mailing Address
First Line : 3127 US HIGHWAY 98 N
Second Line :
City : LAKELAND
State : FL
Zip : 33805-2103
Country : US
Telephone Number : 863-665-8881
Fax Number : 863-665-8851
Provider Business Practice Location Address
First Line : 3127 US HIGHWAY 98 N
Second Line :
City : LAKELAND
State : FL
Zip : 33805-2103
Country : US
Telephone Number : 863-665-8881
Fax Number : 863-665-8851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2012
Last Update Date : 09/13/2018

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Directions to “ MARY M KRELL PT” Practice Location

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