Provider Demographics
NPI:1356674923
Name:NAVARRO, KATHERINE NICOLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:NICOLE
Last Name:NAVARRO
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:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:KS
Mailing Address - Zip Code:67878-0601
Mailing Address - Country:US
Mailing Address - Phone:719-649-4438
Mailing Address - Fax:
Practice Address - Street 1:101 E FULTON ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5455
Practice Address - Country:US
Practice Address - Phone:620-275-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL 10541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist