Provider Demographics
NPI:1801208897
Name:CHIET, KATIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:CHIET
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PALM BEACH PLANTATION BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4556
Mailing Address - Country:US
Mailing Address - Phone:561-707-7019
Mailing Address - Fax:
Practice Address - Street 1:103 PALM BEACH PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4556
Practice Address - Country:US
Practice Address - Phone:561-707-7019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist