Provider Demographics
NPI:1801923354
Name:VLCKOVA, KATERINA (MPT)
Entity type:Individual
Prefix:MRS
First Name:KATERINA
Middle Name:
Last Name:VLCKOVA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 K ST NW
Mailing Address - Street 2:STE. 500
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1003
Mailing Address - Country:US
Mailing Address - Phone:202-463-7611
Mailing Address - Fax:202-463-7669
Practice Address - Street 1:2021 K ST NW
Practice Address - Street 2:STE. 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1003
Practice Address - Country:US
Practice Address - Phone:202-463-7611
Practice Address - Fax:202-463-7669
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist