Provider Demographics
NPI:1083911861
Name:DELCONTIVO, KATHERINE THERESA (MA, ATC, LAT)
Entity Type:Individual
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First Name:KATHERINE
Middle Name:THERESA
Last Name:DELCONTIVO
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Gender:F
Credentials:MA, ATC, LAT
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Mailing Address - Street 1:7300 REINHARDT CIR
Mailing Address - Street 2:
Mailing Address - City:WALESKA
Mailing Address - State:GA
Mailing Address - Zip Code:30183-2981
Mailing Address - Country:US
Mailing Address - Phone:770-720-5821
Mailing Address - Fax:770-720-5752
Practice Address - Street 1:7300 REINHARDT CIR
Practice Address - Street 2:
Practice Address - City:WALESKA
Practice Address - State:GA
Practice Address - Zip Code:30183-2981
Practice Address - Country:US
Practice Address - Phone:770-720-5821
Practice Address - Fax:770-720-5752
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2014-07-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer