Provider Demographics
NPI:1659258275
Name:BURKHOLDER, KILA ANNETTE (LMT)
Entity type:Individual
Prefix:
First Name:KILA
Middle Name:ANNETTE
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SCHUBERT RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:PA
Mailing Address - Zip Code:19507-9662
Mailing Address - Country:US
Mailing Address - Phone:406-609-8101
Mailing Address - Fax:
Practice Address - Street 1:202 S 3RD ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-1845
Practice Address - Country:US
Practice Address - Phone:717-769-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG016419225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist