Provider Demographics
NPI:1295217412
Name:LOCHIATTO, KATHERINE CARMEN (LAT, ATC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CARMEN
Last Name:LOCHIATTO
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 ABBA DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6715
Mailing Address - Country:US
Mailing Address - Phone:508-472-9270
Mailing Address - Fax:
Practice Address - Street 1:1229 FRIENDSHIP RD # 100
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5608
Practice Address - Country:US
Practice Address - Phone:770-532-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0034692255A2300X
GA12751363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer