Doctor Name: | DR. RYAN KUDELKO |
NPI Number: | 1982005070 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PT21300 |
Business Practice Address: | 1505 Lori Ln Hermitage, PA - 161487719 |
Business Phone Number: | 7248662880 |
Business Fax Number: | 7249835973 |
Mailing Address: | 1505 Lori Ln, HERMITAGE |
State: | PA |
Postal Code: | 161487719 |
Phone Number: | 7248662880 |
Fax Number: | 7249835973 |
NPI Enumeration Date: | 09/09/2014 |
NPI Last Update Date: | 09/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT21300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |