Provider Demographics
NPI:1124254065
Name:MITCHELL, KATHRYN D (PT, DPT, NCS)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:D
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:245 N 15TH ST # MS 502
Mailing Address - Street 2:ROOM 940
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1101
Mailing Address - Country:US
Mailing Address - Phone:215-762-1749
Mailing Address - Fax:215-762-3886
Practice Address - Street 1:245 N 15TH ST # MS 502
Practice Address - Street 2:ROOM 940
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:215-762-1749
Practice Address - Fax:215-762-3886
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT6495L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist