Provider Demographics
NPI:1124727086
Name:PEARAGE, KRISTI MARIE (DPT)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:MARIE
Last Name:PEARAGE
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 1:4 NASH LN
Mailing Address - Street 2:
Mailing Address - City:BEAR CREEK TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18702-9324
Mailing Address - Country:US
Mailing Address - Phone:570-855-2325
Mailing Address - Fax:
Practice Address - Street 1:395 ROUTE 940 EAST
Practice Address - Street 2:
Practice Address - City:BLAKESLEE
Practice Address - State:PA
Practice Address - Zip Code:18610
Practice Address - Country:US
Practice Address - Phone:272-639-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist