Provider Demographics
NPI:1316219603
Name:POE, KATHERINE A (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A
Last Name:POE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6188 OXON HILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3149
Mailing Address - Country:US
Mailing Address - Phone:301-839-0500
Mailing Address - Fax:301-839-2835
Practice Address - Street 1:6188 OXON HILL RD STE 101
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3149
Practice Address - Country:US
Practice Address - Phone:301-839-0500
Practice Address - Fax:301-839-2835
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03582111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation