Provider Demographics
NPI:1871348680
Name:KRAUS, DENNIS MARTIN (PTA)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:MARTIN
Last Name:KRAUS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 DAVID DR APT B
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-5232
Mailing Address - Country:US
Mailing Address - Phone:484-280-8143
Mailing Address - Fax:
Practice Address - Street 1:2410 DAVID DR APT B
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-5232
Practice Address - Country:US
Practice Address - Phone:484-280-8143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1005056225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant