Provider Demographics
NPI:1972285708
Name:EVERTON, KATHRYN ALISE (DPT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ALISE
Last Name:EVERTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6200 PIEDMONT RIDGE CIR UNIT 303
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-4690
Mailing Address - Country:US
Mailing Address - Phone:978-460-7241
Mailing Address - Fax:
Practice Address - Street 1:3708 MAYFAIR ST STE 110
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6223
Practice Address - Country:US
Practice Address - Phone:984-215-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist