Provider Demographics
NPI:1811677008
Name:GUNCHEON, KATHRYN GREER GERARD (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:GREER GERARD
Last Name:GUNCHEON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9190 CLEARSTREAM TER
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-5186
Mailing Address - Country:US
Mailing Address - Phone:804-443-7972
Mailing Address - Fax:
Practice Address - Street 1:919 STATE AVE STE 101
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4284
Practice Address - Country:US
Practice Address - Phone:804-443-7972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP022577T225100000X
VA2305214265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist