Provider Demographics
NPI:1366583627
Name:DALLEY, KENDRA A (PT)
Entity type:Individual
Prefix:MR
First Name:KENDRA
Middle Name:A
Last Name:DALLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 YANKEE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17065-1036
Mailing Address - Country:US
Mailing Address - Phone:717-486-4317
Mailing Address - Fax:
Practice Address - Street 1:112 N 7TH ST
Practice Address - Street 2:CHAMBERSBURG HOSPITAL - PHYSICAL MEDICINE DEPARTMENT
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1720
Practice Address - Country:US
Practice Address - Phone:717-267-7715
Practice Address - Fax:717-267-7463
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013226L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist