Provider Demographics
NPI:1700288610
Name:CARLEY, KATHRYN K
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:K
Last Name:CARLEY
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 1:110 HAVERHILL RD
Mailing Address - Street 2:STE 524
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2123
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:30 LANCASTER ST
Practice Address - Street 2:STE 100
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1704
Practice Address - Country:US
Practice Address - Phone:617-367-4700
Practice Address - Fax:617-367-4701
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist