Provider Demographics
NPI:1942770672
Name:HAYWORTH, CATHERINE ELIZABETH (PTA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:HAYWORTH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:115 W BROADWAY BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-5708
Practice Address - Country:US
Practice Address - Phone:660-827-2942
Practice Address - Fax:660-827-2961
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018037350225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant