Provider Demographics
NPI:1992053524
Name:FACTOR, KATHERINE CONLEY (PT)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CONLEY
Last Name:FACTOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1372 EAST ZION WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249
Mailing Address - Country:US
Mailing Address - Phone:480-748-1195
Mailing Address - Fax:
Practice Address - Street 1:1372 EAST ZION WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249
Practice Address - Country:US
Practice Address - Phone:480-748-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist