Provider Demographics
NPI:1760298749
Name:DAMERA, VENKATA L S KRUTHIKA (PT)
Entity type:Individual
Prefix:
First Name:VENKATA L S KRUTHIKA
Middle Name:
Last Name:DAMERA
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 1:560 N ROUTE 100
Mailing Address - Street 2:
Mailing Address - City:BECHTELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19505-9228
Mailing Address - Country:US
Mailing Address - Phone:610-845-5000
Mailing Address - Fax:610-845-5011
Practice Address - Street 1:3887 SKIPPACK PIKE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474-1487
Practice Address - Country:US
Practice Address - Phone:610-584-1400
Practice Address - Fax:610-584-5224
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist