Provider Demographics
NPI:1578174926
Name:TRULUCK, KATIE ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:ANN
Last Name:TRULUCK
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 1:210 ARTHUR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2701
Mailing Address - Country:US
Mailing Address - Phone:407-924-2227
Mailing Address - Fax:
Practice Address - Street 1:3721 NEW MACLAND RD STE 530
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2089
Practice Address - Country:US
Practice Address - Phone:407-924-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist