Provider Demographics
NPI:1922546373
Name:SLATER, KATHRYN LUDLOW (DPT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LUDLOW
Last Name:SLATER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:LADELLE
Other - Last Name:LUDLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 EASTONBURY CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-4782
Mailing Address - Country:US
Mailing Address - Phone:817-913-5826
Mailing Address - Fax:
Practice Address - Street 1:30 W BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2101
Practice Address - Country:US
Practice Address - Phone:610-626-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025824225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist