Basic Information
Provider Information
NPI: 1154689958
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAMBERS
FirstName: KATHRYN
MiddleName: LOUISE
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 15 JANE JACOBS RD
Address2: SUITE 202
City: BLACK MOUNTAIN
State: NC
PostalCode: 287116306
CountryCode: US
TelephoneNumber: 8286698643
FaxNumber: 8286698648
Practice Location
Address1: 2585 HENDERSONVILLE RD
Address2:  
City: ARDEN
State: NC
PostalCode: 287049577
CountryCode: US
TelephoneNumber: 8282588800
FaxNumber: 8286510026
Other Information
ProviderEnumerationDate: 04/30/2012
LastUpdateDate: 04/16/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X13520NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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