Provider Demographics
NPI:1790115962
Name:STEIN, KATIBETH ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATIBETH
Middle Name:ANN
Last Name:STEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATIBETH
Other - Middle Name:ANN
Other - Last Name:MOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials: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:423-238-3473
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:7805 ABERCORN ST STE 21
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2457
Practice Address - Country:US
Practice Address - Phone:912-356-3559
Practice Address - Fax:912-691-4902
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7206225100000X
GAPT011875225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist