Provider Demographics
NPI:1619115573
Name:TODD, KATRINA R (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:R
Last Name:TODD
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Gender:F
Credentials:PHYSICAL THERAPY
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Mailing Address - Street 1:729 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 4C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4217
Mailing Address - Country:US
Mailing Address - Phone:757-873-2932
Mailing Address - Fax:757-597-9514
Practice Address - Street 1:729 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 4C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4217
Practice Address - Country:US
Practice Address - Phone:757-873-2932
Practice Address - Fax:757-597-9514
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305205733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist