Provider Demographics
NPI:1205341450
Name:SAVAGE, KATHERINE L
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:SAVAGE
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 1:425 SUMMIT TERRACE CT BLDG B5
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7055
Mailing Address - Country:US
Mailing Address - Phone:803-605-8413
Mailing Address - Fax:
Practice Address - Street 1:425 SUMMIT TERRACE CT STE B5
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7055
Practice Address - Country:US
Practice Address - Phone:803-605-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management