Provider Demographics
NPI:1245099308
Name:MARTINI, KATELYN TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:TAYLOR
Last Name:MARTINI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:BURRELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:335 LAPORTE CT
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4927
Mailing Address - Country:US
Mailing Address - Phone:724-674-7439
Mailing Address - Fax:
Practice Address - Street 1:9795 PERRY HWY STE 101
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9700
Practice Address - Country:US
Practice Address - Phone:412-366-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT03121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist