Provider Demographics
NPI:1083985444
Name:ROLLINS, KATRINA JEAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:JEAN
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-5827
Mailing Address - Country:US
Mailing Address - Phone:606-571-7676
Mailing Address - Fax:
Practice Address - Street 1:3100 CHARLES ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-5827
Practice Address - Country:US
Practice Address - Phone:606-571-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0050302251G0304X
OH0116782251G0304X
WV0028032251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics