Provider Demographics
NPI:1841070737
Name:WOLFE, KATHRYN (DPT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 JOHNSON FERRY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5416
Mailing Address - Country:US
Mailing Address - Phone:470-363-3332
Mailing Address - Fax:
Practice Address - Street 1:780 8TH AVE STE 202
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-7000
Practice Address - Country:US
Practice Address - Phone:212-245-1841
Practice Address - Fax:623-239-0100
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist