Provider Demographics
NPI:1043380694
Name:WEBB, KATHRYN A (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:A
Last Name:WEBB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:JABLONSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:211 BOBBY JONES EXPY
Mailing Address - Street 2:STE C
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5250
Mailing Address - Country:US
Mailing Address - Phone:706-860-3355
Mailing Address - Fax:706-860-8765
Practice Address - Street 1:211 BOBBY JONES EXPY
Practice Address - Street 2:STE C
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5250
Practice Address - Country:US
Practice Address - Phone:706-860-3355
Practice Address - Fax:706-860-8765
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GRP3167OtherOFFICE GROUP MEDICARE
U22852Medicare UPIN
GRP3167OtherOFFICE GROUP MEDICARE