Provider Demographics
NPI:1841547908
Name:DAVIS, KATHRINE ANN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:KATHRINE
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208B SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-2231
Mailing Address - Country:US
Mailing Address - Phone:615-666-7008
Mailing Address - Fax:
Practice Address - Street 1:1208B SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-2231
Practice Address - Country:US
Practice Address - Phone:615-666-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist