Provider Demographics
NPI:1922209626
Name:NEVILLE, KATHARINE JOYCE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:JOYCE
Last Name:NEVILLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:KATHARINE
Other - Middle Name:JOYCE
Other - Last Name:LEHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6 PALISADES VIEW COURT
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025
Mailing Address - Country:US
Mailing Address - Phone:636-938-6650
Mailing Address - Fax:
Practice Address - Street 1:70 E NORTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-1205
Practice Address - Country:US
Practice Address - Phone:636-938-4065
Practice Address - Fax:636-938-4067
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002006962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist