Basic Information
Provider Information
NPI: 1881325397
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: KATHERINE
MiddleName:  
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Credential:  
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Mailing Information
Address1: 6397 LEE HWY STE 300
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374214915
CountryCode: US
TelephoneNumber: 8665180283
FaxNumber:  
Practice Location
Address1: 990 E MAIN ST STE 7
Address2:  
City: BLUE RIDGE
State: GA
PostalCode: 305134534
CountryCode: US
TelephoneNumber: 7069462035
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/23/2022
LastUpdateDate: 06/23/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 06/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT015995GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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