Healthcare Provider Details

I. General information

NPI: 1548396286
Provider Name (Legal Business Name): JENNIFER LYNN CATALFANO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HORIZON DR SUITE 115
RALEIGH NC
27615-4946
US

IV. Provider business mailing address

200 HORIZON DR SUITE 115
RALEIGH NC
27615-4946
US

V. Phone/Fax

Practice location:
  • Phone: 919-875-1932
  • Fax: 919-875-1933
Mailing address:
  • Phone: 919-875-1932
  • Fax: 919-875-1933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number10964
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: