Provider Demographics
NPI:1952831166
Name:HEATH, KARA FLORENCE (DPT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:FLORENCE
Last Name:HEATH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:HEATH
Other - Last Name:JESSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4TH MEDICAL GROUP
Mailing Address - Street 2:2803 MEDICAL CAMPUS DRIVE
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27531
Mailing Address - Country:US
Mailing Address - Phone:919-722-8463
Mailing Address - Fax:
Practice Address - Street 1:4TH MEDICAL GROUP
Practice Address - Street 2:2803 MEDICAL CAMPUS DRIVE
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27531
Practice Address - Country:US
Practice Address - Phone:919-722-8463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017017380225100000X
MO2017027518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist