Provider Demographics
NPI:1639329394
Name:CEBO, KATHLEEN (PT, DPT, ATC, VATL)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:CEBO
Suffix:
Gender:F
Credentials:PT, DPT, ATC, VATL
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:776 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3728
Mailing Address - Country:US
Mailing Address - Phone:757-389-7900
Mailing Address - Fax:
Practice Address - Street 1:776 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3728
Practice Address - Country:US
Practice Address - Phone:757-389-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist