Provider Demographics
NPI:1306286620
Name:CONDES, KATHERINE PILAR (PT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:PILAR
Last Name:CONDES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:PILAR
Other - Middle Name:
Other - Last Name:CONDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:4305 OAK PARK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5639
Mailing Address - Country:US
Mailing Address - Phone:843-609-8404
Mailing Address - Fax:
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-781-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist