Provider Demographics
NPI:1780633370
Name:WADSWORTH, KATHERINE J (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:J
Last Name:WADSWORTH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5509 SICILY RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4775
Mailing Address - Country:US
Mailing Address - Phone:505-856-6982
Mailing Address - Fax:
Practice Address - Street 1:2607 WYOMING BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1029
Practice Address - Country:US
Practice Address - Phone:505-296-9521
Practice Address - Fax:505-296-2200
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist