Provider Demographics
NPI:1427592799
Name:RHOADES, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SIPE RD
Mailing Address - Street 2:
Mailing Address - City:VOLANT
Mailing Address - State:PA
Mailing Address - Zip Code:16156-1918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 SIPE RD
Practice Address - Street 2:
Practice Address - City:VOLANT
Practice Address - State:PA
Practice Address - Zip Code:16156-1918
Practice Address - Country:US
Practice Address - Phone:570-974-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist