Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT025465 | PA |
NPI | 1053876474 |
---|---|
Provider Name | Kiersten Rebecca Sell |
First Address | New Oxford, PA 17350-8883 |
Second Address | Camp Hill, PA 17011-2910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2019 |
Last Update Date | 11/02/2019 |