Provider Demographics
NPI:1689833972
Name:PRITCHARD, KATIE GRACE (PT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:GRACE
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:GRACE
Other - Last Name:HENDERSHOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2920186OtherUNITED HEALTHCARE
47241OtherGEISINGER HEALTH PLAN
50079219OtherCAPITAL BLUE CROSS
3530702000OtherINDEPENDENCE BLUE CROSS
50079219OtherKEYSTONE HEALTH PLAN CENTRAL
3530702000OtherAMERIHEALTH
3530702000OtherKEYSTONE HEALTH PLAN EAST