Kaitlin Shanafelt
Individual provider Active NPI Physical Therapy Assistant · Tyrone, PA
NPI 1780416768 · NPPES record last updated Aug 19, 2024
Key facts
- NPI
- 1780416768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- TEI006569 (PA)
- Practice address
- 171 Frederick St
Tyrone, PA 16686-6801 - Phone
- (814) 650-4004
- NPI assigned
- Aug 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEI006569 | PA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TEI006569 | PA | Yes |
Addresses
Primary practice location
171 Frederick St
Tyrone, PA 16686-6801
Mailing address
171 Frederick St
Tyrone, PA 16686-6801
Phone (814) 650-4004
Other providers in Tyrone, PA
- Hil X Rizvi
- Alysen Roscia
- Victor H Santillan
- John A Schroth
- Shane Sergent
- Jaelyn Shaw
- Marianne L Shaw
- Jacob Richard Shelow
- Timothy Stephen Skarada
- Robert James Sloss
All providers in Tyrone, PA · Physical Therapy Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.