Provider Demographics
NPI:1023663143
Name:CARNELL, KRISTIN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:CARNELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3236 SUMMER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW RINGGOLD
Mailing Address - State:PA
Mailing Address - Zip Code:17960-9372
Mailing Address - Country:US
Mailing Address - Phone:814-934-2990
Mailing Address - Fax:
Practice Address - Street 1:4136 W TILGHMAN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4428
Practice Address - Country:US
Practice Address - Phone:484-822-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT005801225100000X
PAPT027907225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist