Provider Demographics
NPI:1902531684
Name:KALTREIDER, SARAH MARIE (LMT, PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:KALTREIDER
Suffix:
Gender:F
Credentials:LMT, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WERTZVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-2031
Mailing Address - Country:US
Mailing Address - Phone:717-965-2831
Mailing Address - Fax:
Practice Address - Street 1:401 WERTZVILLE RD
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-2031
Practice Address - Country:US
Practice Address - Phone:717-965-2831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG012628225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty