Provider Demographics
NPI:1689915985
Name:OSBORNE, KATHERINE VICTORIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:VICTORIA
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:VICTORIA
Other - Last Name:RICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:119 CANAL ST
Practice Address - Street 2:STE 104
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4095
Practice Address - Country:US
Practice Address - Phone:912-330-8444
Practice Address - Fax:912-330-8844
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0109202251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics