Individual
KERRY LYNN KREIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
333 WHEAT RIDGE DR, EPHRATA, PA 17522-8558
(717) 354-1858
(717) 354-1873
Mailing address
5945 REEVES RD, EAST PETERSBURG, PA 17520-1530
(717) 581-5202
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009063
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
395805
PROVIDER NUMBER
PA
Enumeration date
11/24/2009
Last updated
11/24/2009
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