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NPI Code Detail

MEDICARE: KATHRYNE SUZANNE BEVER PT, DPT

MEDICARE: KATHRYNE SUZANNE BEVER 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
1225100000XPhysical Therapist2019021857MO
2225100000XPhysical Therapist11-06111KS

General Provider Information

NPI Number : 1912565094
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYNE SUZANNE BEVER PT, DPT
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-4915
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 3355 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1904
Country : US
Telephone Number : 816-399-0806
Fax Number : 816-743-7413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2019
Last Update Date : 06/20/2019

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