Provider Demographics
NPI:1386798767
Name:OPTON, KATHRYNE ELLEN (M ED, LMT, NASM-CPT)
Entity type:Individual
Prefix:MRS
First Name:KATHRYNE
Middle Name:ELLEN
Last Name:OPTON
Suffix:
Gender:F
Credentials:M ED, LMT, NASM-CPT
Other - Prefix:
Other - First Name:KATHRYNE
Other - Middle Name:
Other - Last Name:OPTON-FOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8409 SW 8TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4925
Mailing Address - Country:US
Mailing Address - Phone:352-870-9800
Mailing Address - Fax:
Practice Address - Street 1:8409 SW 8TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4925
Practice Address - Country:US
Practice Address - Phone:352-870-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA47991225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist