Provider Demographics
NPI:1003859562
Name:MCKNEW, KATHERINE ALLEN (PT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ALLEN
Last Name:MCKNEW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:FAIRFAX
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3754 CLIPPER BAY DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2944
Mailing Address - Country:US
Mailing Address - Phone:804-445-5532
Mailing Address - Fax:
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist