Provider Demographics
NPI:1942216262
Name:NEWTON, KATHERINE E
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:NEWTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 ARMSTRONG FORD RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-8362
Mailing Address - Country:US
Mailing Address - Phone:803-673-9584
Mailing Address - Fax:
Practice Address - Street 1:223 S HERLONG AVE STE 110
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1089
Practice Address - Country:US
Practice Address - Phone:803-980-5080
Practice Address - Fax:803-980-5083
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC225000000X225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2524Medicaid
SCDE2524Medicaid