Healthcare Provider Details

I. General information

NPI: 1568518454
Provider Name (Legal Business Name): KATHLEEN M MONIZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 OLD MAIN RD
NORTH FALMOUTH MA
02556-2704
US

IV. Provider business mailing address

93 OLD MAIN RD
NORTH FALMOUTH MA
02556-2704
US

V. Phone/Fax

Practice location:
  • Phone: 508-564-5620
  • Fax: 508-564-5620
Mailing address:
  • Phone: 508-564-5620
  • Fax: 508-564-5620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3740
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: