Basic Information
Provider Information
NPI: 1063845915
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PHILPOTT
FirstName: KATHERINE
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8 HOSPITAL CENTER BLVD STE 250
Address2:  
City: HILTON HEAD ISLAND
State: SC
PostalCode: 299268702
CountryCode: US
TelephoneNumber: 8436717342
FaxNumber: 8436717343
Practice Location
Address1: 8 HOSPITAL CENTER BLVD STE 250
Address2:  
City: HILTON HEAD ISLAND
State: SC
PostalCode: 299268702
CountryCode: US
TelephoneNumber: 8436717342
FaxNumber: 8436717343
Other Information
ProviderEnumerationDate: 08/14/2013
LastUpdateDate: 08/14/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X7128SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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