Provider Demographics
NPI:1679522783
Name:CZUPRYNSKI, KENNETH JOSEPH (MPT, MTC)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:JOSEPH
Last Name:CZUPRYNSKI
Suffix:
Gender:M
Credentials:MPT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:123 N MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MERCERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17236-1723
Mailing Address - Country:US
Mailing Address - Phone:717-328-2121
Mailing Address - Fax:717-328-2127
Practice Address - Street 1:123 N MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MERCERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17236-1723
Practice Address - Country:US
Practice Address - Phone:717-328-2121
Practice Address - Fax:717-328-2127
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT005903L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist