Provider Demographics
NPI:1881893857
Name:CHASE, KATHERINE A (PT)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:A
Last Name:CHASE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:WILBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1812
Mailing Address - Country:US
Mailing Address - Phone:413-527-5552
Mailing Address - Fax:
Practice Address - Street 1:3550 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1089
Practice Address - Country:US
Practice Address - Phone:413-734-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist