Provider Demographics
NPI:1528271863
Name:OSBORNE, MARY KATHRYN (PT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 GREEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2504
Mailing Address - Country:US
Mailing Address - Phone:336-580-2514
Mailing Address - Fax:
Practice Address - Street 1:2008 NEW GARDEN RD STE D
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2526
Practice Address - Country:US
Practice Address - Phone:336-847-8697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist