Provider Demographics
NPI:1427415975
Name:MCKAY, KATHERINE DIANE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DIANE
Last Name:MCKAY
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 1:32900 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-2018
Mailing Address - Country:US
Mailing Address - Phone:440-937-6201
Mailing Address - Fax:
Practice Address - Street 1:4724 DOVER CENTER RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-2608
Practice Address - Country:US
Practice Address - Phone:440-937-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.015002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist