Healthcare Provider Details

I. General information

NPI: 1801922778
Provider Name (Legal Business Name): KATHRYN WILSON D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN YEARSLEY P.T.

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 09/17/2026
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 CENTER ROAD
VENICE FL
34285
US

IV. Provider business mailing address

181 CENTER RD
VENICE FL
34285
US

V. Phone/Fax

Practice location:
  • Phone: 941-479-9894
  • Fax:
Mailing address:
  • Phone: 941-479-9894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT18431
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: