Provider Demographics
NPI:1578183489
Name:KETTERMAN, ABIGALE (MS, LAT, ATC, CES)
Entity type:Individual
Prefix:
First Name:ABIGALE
Middle Name:
Last Name:KETTERMAN
Suffix:
Gender:F
Credentials:MS, LAT, ATC, CES
Other - Prefix:
Other - First Name:ABIGALE
Other - Middle Name:
Other - Last Name:NOWKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LAT, ATC, CES
Mailing Address - Street 1:2 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1861 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4723
Practice Address - Country:US
Practice Address - Phone:717-718-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0065692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer