Provider Demographics
NPI:1174946016
Name:KIRCHNER, JANA KAY (PTA)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:KAY
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3703
Mailing Address - Country:US
Mailing Address - Phone:319-473-0137
Mailing Address - Fax:
Practice Address - Street 1:20 VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-2040
Practice Address - Country:US
Practice Address - Phone:319-524-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005074225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant