Provider Demographics
NPI:1609226265
Name:NATHAN, KATHRYN (DPT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:NATHAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:NATHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4420 BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3317
Mailing Address - Country:US
Mailing Address - Phone:818-640-8018
Mailing Address - Fax:
Practice Address - Street 1:4420 BEL AIRE DR
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-3317
Practice Address - Country:US
Practice Address - Phone:818-640-8018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist