Provider Demographics
NPI:1841035045
Name:MCDONALD, KAITLYN ROSE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ROSE
Last Name:MCDONALD
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 1:191 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-1814
Mailing Address - Country:US
Mailing Address - Phone:978-499-1870
Mailing Address - Fax:
Practice Address - Street 1:191 ELM ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-1814
Practice Address - Country:US
Practice Address - Phone:978-499-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist