Healthcare Provider Details

I. General information

NPI: 1952130395
Provider Name (Legal Business Name): CATHERINE BREWINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 JEFFERSON HWY STE 102
LOUISA VA
23093-6563
US

IV. Provider business mailing address

115 JEFFERSON HWY STE 102
LOUISA VA
23093-6563
US

V. Phone/Fax

Practice location:
  • Phone: 540-967-1757
  • Fax: 540-500-5879
Mailing address:
  • Phone: 540-967-1757
  • Fax: 540-500-5879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305216805
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: