Individual
KRISTEN KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 UNION ST, BEDFORD, PA 15522-1723
(814) 494-5883
Mailing address
128 UNION ST, BEDFORD, PA 15522-1723
(814) 494-5883
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006294
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP006294
LICENSE
PA
Enumeration date
02/20/2019
Last updated
02/20/2019
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