Provider Demographics
NPI:1992908842
Name:KNISELY, MARY S (PT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:S
Last Name:KNISELY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:CLAIRE
Other - Last Name:SCHILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:106 BATTLE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2353
Mailing Address - Country:US
Mailing Address - Phone:610-918-8336
Mailing Address - Fax:
Practice Address - Street 1:99 MANOR AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2620
Practice Address - Country:US
Practice Address - Phone:610-518-5845
Practice Address - Fax:610-518-5846
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0180252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic