Provider Demographics
NPI:1629258017
Name:BURNS-CARNE, KATHLEEN MARIE (PT, DPT, ATC)
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:BURNS-CARNE
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC
Mailing Address - Street 1:920 PLANTATION RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-3835
Mailing Address - Country:US
Mailing Address - Phone:540-951-0742
Mailing Address - Fax:540-951-0743
Practice Address - Street 1:920 PLANTATION RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-3835
Practice Address - Country:US
Practice Address - Phone:540-951-0742
Practice Address - Fax:540-951-0743
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205211225100000X
NY0203023692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer