MEDICARE: KATE MARIE GILRAIN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 23561	FL

General Provider Information

NPI Number	:	1811136633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE MARIE GILRAIN PT, DPT

Provider Business Mailing Address
First Line	:	PO BOX 778
Second Line	:
City	:	PALATKA
State	:	FL
Zip	:	32178-0778
Country	:	US
Telephone Number	:	386-326-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 ZEAGLER DR
Second Line	:
City	:	PALATKA
State	:	FL
Zip	:	32177-6806
Country	:	US
Telephone Number	:	386-326-8500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2009
Last Update Date	:	11/13/2013

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