Provider Demographics
NPI:1841840816
Name:WILKINSON, KATHRYN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08882-1451
Mailing Address - Country:US
Mailing Address - Phone:732-272-7290
Mailing Address - Fax:
Practice Address - Street 1:65 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1869
Practice Address - Country:US
Practice Address - Phone:732-747-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01860300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist