Provider Demographics
NPI:1134313521
Name:KATHERINE M PAPAZOGLOU
Entity Type:Organization
Organization Name:KATHERINE M PAPAZOGLOU
Other - Org Name:ESSENTIAL THERAPEUTICS & WELLNESS, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PAPAZOGLOU
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPY
Authorized Official - Phone:570-856-5991
Mailing Address - Street 1:3003 HAMILTON E BUSINESS ROUTE 209
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360
Mailing Address - Country:US
Mailing Address - Phone:570-992-4007
Mailing Address - Fax:570-992-4077
Practice Address - Street 1:3003 HAMILTON E BUSINESS ROUTE 209
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360
Practice Address - Country:US
Practice Address - Phone:570-992-4007
Practice Address - Fax:570-992-4077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002614E261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy