Healthcare Provider Details
I. General information
NPI: 1215551668
Provider Name (Legal Business Name): KATHERINE HOGUE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/02/2020
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34434 KING STREET ROW STE 1
LEWES DE
19958-4987
US
IV. Provider business mailing address
659 S SALISBURY BLVD STE 1B
SALISBURY MD
21801-5458
US
V. Phone/Fax
- Phone: 302-200-9920
- Fax: 302-703-6652
- Phone: 410-831-3226
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PENDING |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: