Provider Demographics
NPI:1275926438
Name:BOOTH, KATHRYN (PT, DPT, NCS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:BOOTH
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:KAYLEA
Other - Middle Name:
Other - Last Name:BOOTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT, NCS
Mailing Address - Street 1:232 BOONE HEIGHTS DR STE A
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:232 BOONE HEIGHTS DR STE A
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4926
Practice Address - Country:US
Practice Address - Phone:828-268-9043
Practice Address - Fax:828-268-9045
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP148112251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology