Basic Information
Provider Information
NPI: 1164729133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUSTED
FirstName: KATHRYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
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Mailing Information
Address1: 211 FRIDAY CENTER DR
Address2: SUITE 2091, ROOM 2102
City: CHAPEL HILL
State: NC
PostalCode: 275179499
CountryCode: US
TelephoneNumber: 9199665804
FaxNumber: 9199669983
Practice Location
Address1: 101 MANNING DR
Address2: DEPT OF PHYSICAL THERAPY
City: CHAPEL HILL
State: NC
PostalCode: 275144220
CountryCode: US
TelephoneNumber: 9198431890
FaxNumber: 9199660348
Other Information
ProviderEnumerationDate: 02/28/2011
LastUpdateDate: 02/28/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XP11286NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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