Provider Demographics
NPI:1104597517
Name:POLLARD, KATRINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:POLLARD
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 1:7 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:MA
Mailing Address - Zip Code:01504-1335
Mailing Address - Country:US
Mailing Address - Phone:177-436-4343
Mailing Address - Fax:
Practice Address - Street 1:3179 MAIN ST
Practice Address - Street 2:
Practice Address - City:BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02630-1105
Practice Address - Country:US
Practice Address - Phone:508-209-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist