Provider Demographics
NPI:1093799785
Name:HOWARD, KATHARYN CROZIER (DPT)
Entity type:Individual
Prefix:
First Name:KATHARYN
Middle Name:CROZIER
Last Name:HOWARD
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 1:19 SWAN ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3119
Mailing Address - Country:US
Mailing Address - Phone:978-636-5200
Mailing Address - Fax:781-208-0918
Practice Address - Street 1:19 SWAN ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3119
Practice Address - Country:US
Practice Address - Phone:978-636-5200
Practice Address - Fax:781-208-0918
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203986225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist