Healthcare Provider Details

I. General information

NPI: 1588777965
Provider Name (Legal Business Name): CATHERINE FAULS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 DIXIE HWY STE A
FT WRIGHT KY
41011-2766
US

IV. Provider business mailing address

2226 ARBOUR WALK CIR APT 1928
NAPLES FL
34109-8804
US

V. Phone/Fax

Practice location:
  • Phone: 859-578-0022
  • Fax: 859-441-6380
Mailing address:
  • Phone: 239-961-4048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006027
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: