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Organization
KINETIC REHAB LLC
Active
Organization
KINETIC REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN S WALLACE DPT (PRESIDENT)
(724) 713-1964
Entity
Organization
Contact information
Practice address
2373 DELO DR, GIBSONIA, PA 15044-9158
(724) 713-1964
(412) 202-9770
Mailing address
2373 DELO DR, GIBSONIA, PA 15044-9158
(724) 713-1964
(412) 202-9770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016454
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101794666 0001
—
PA
Enumeration date
04/18/2007
Last updated
08/22/2020
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