Provider Demographics
NPI:1215436324
Name:PALAZZO, KATHERINE BLAIR
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BLAIR
Last Name:PALAZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 OAKLAND AVE APT M
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-3678
Mailing Address - Country:US
Mailing Address - Phone:518-935-3128
Mailing Address - Fax:
Practice Address - Street 1:1400 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-5015
Practice Address - Country:US
Practice Address - Phone:336-334-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer