Provider Demographics
NPI:1508590258
Name:RHODES, CATHERINE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:PTA
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 288
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-0288
Mailing Address - Country:US
Mailing Address - Phone:304-822-2177
Mailing Address - Fax:540-536-3284
Practice Address - Street 1:25072 NORTHWESTERN PIKE
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-5039
Practice Address - Country:US
Practice Address - Phone:304-822-2177
Practice Address - Fax:540-536-3284
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV000838225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant