Individual
KIMBERLY PETUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
58 NEITZ RD, NORTHUMBERLAND, PA 17857-9608
(570) 473-8366
Mailing address
2447 3RD ST, BLOOMSBURG, PA 17815-3118
(570) 316-8232
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
TEI000695
PA
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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