Provider Demographics
NPI:1912572835
Name:MCCRARY, KATHERINE VIRGINIA (DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:VIRGINIA
Last Name:MCCRARY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHERIN
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:
Practice Address - Street 1:12850 HIGHWAY 9 N STE 1050
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-4669
Practice Address - Country:US
Practice Address - Phone:678-332-5800
Practice Address - Fax:678-681-9004
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist