Provider Demographics
NPI:1225538416
Name:BERRY, KATLYN ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KATLYN
Middle Name:ELIZABETH
Last Name:BERRY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:KATLYN
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4013 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-6079
Mailing Address - Country:US
Mailing Address - Phone:903-818-2122
Mailing Address - Fax:
Practice Address - Street 1:3400 WATERVIEW PKWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1472
Practice Address - Country:US
Practice Address - Phone:469-341-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist