Provider Demographics
NPI:1265617054
Name:GIAMMONA, KATHERINE LYNN (MHS, PT, ATP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LYNN
Last Name:GIAMMONA
Suffix:
Gender:F
Credentials:MHS, PT, ATP
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS, PT
Mailing Address - Street 1:65 BOSTICK CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5708
Mailing Address - Country:US
Mailing Address - Phone:843-592-1026
Mailing Address - Fax:
Practice Address - Street 1:65 BOSTICK CIR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5708
Practice Address - Country:US
Practice Address - Phone:843-592-1026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5202225100000X
225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner