Healthcare Provider Details

I. General information

NPI: 1881583607
Provider Name (Legal Business Name): KATHERINE ANNE MICHOS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WILKES RIDGE DR
RICHMOND VA
23233-7632
US

IV. Provider business mailing address

4820 OLD MAIN ST UNIT 401
RICHMOND VA
23231-3056
US

V. Phone/Fax

Practice location:
  • Phone: 804-877-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217199
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: