Provider Demographics
NPI:1053876474
Name:SELL, KIERSTEN REBECCA (DPT)
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:REBECCA
Last Name:SELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MATTHEW DR
Mailing Address - Street 2:
Mailing Address - City:NEW OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:17350-8883
Mailing Address - Country:US
Mailing Address - Phone:717-850-8008
Mailing Address - Fax:
Practice Address - Street 1:255 N 29TH ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2910
Practice Address - Country:US
Practice Address - Phone:717-516-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0254652251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics