Provider Demographics
NPI:1295373892
Name:OLDS, KATHRYN (PT, DPT, MS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:OLDS
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E WASHINGTON ST STE B1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1867
Mailing Address - Country:US
Mailing Address - Phone:864-729-4081
Mailing Address - Fax:
Practice Address - Street 1:1322 E WASHINGTON ST STE B1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1867
Practice Address - Country:US
Practice Address - Phone:864-729-4081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045417225100000X
SC10098225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist