| Keith Kmieczak, MSPT | |
|
136 Lake St, Suite E, Ephrata, PA 17522 | |
| (717) 466-5880 | |
| Not Available |
| Full Name | Keith Kmieczak |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 136 Lake St, Ephrata, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932181542 | NPI | - | NPPES |
| 2053032000 | Other | PA | INDEPENDENCE BLUE SHIELD |
| 50017328 | Other | PA | CAPITAL BLUE CROSS |
| 2719587 | Other | PA | AETNA |
| 814494 | Other | PA | FIRST PRIORITY |
| 1360739 | Other | PA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT013342L (Pennsylvania) | Primary |
| Provider Name | Drayer Physical Therapy Institute Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1538122700 PECOS PAC ID: 8224948666 Enrollment ID: O20040126000110 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Kmieczak, MSPT 297 Orchard View Dr, Leola, PA 17540-1632 Ph: (717) 283-6797 | Keith Kmieczak, MSPT 136 Lake St, Suite E, Ephrata, PA 17522 Ph: (717) 466-5880 |
William Helm, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 136e Lake St, Ephrata, PA 17522 Phone: 717-738-7979 | |
Dr. Alicia S Feathers, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 333 Wheat Ridge Dr, Ephrata, PA 17522 Phone: 717-354-1858 Fax: 717-354-1873 | |
Danielle Lynn Burns, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 136e Lake St, Ephrata, PA 17522 Phone: 717-738-7979 Fax: 717-738-7970 | |
Yentzu Chen, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 136 Lake St, Ephrata, PA 17522 Phone: 717-466-5880 | |
Jill Aileen Millard, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 169 Martin Ave, Ephrata, PA 17522 Phone: 717-738-6652 | |
Alina Nguyen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 136 Lake St Suite E, Ephrata, PA 17522 Phone: 717-466-5880 | |
James Mckeown, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 136e Lake St, Ephrata, PA 17522 Phone: 717-738-7979 |