Healthcare Provider Details

I. General information

NPI: 1124341656
Provider Name (Legal Business Name): KATHERINE NORA ROOK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W HEMLOCK ST
SEQUIM WA
98382-3718
US

IV. Provider business mailing address

27 DOWNEY DR
HORSHAM PA
19044-1032
US

V. Phone/Fax

Practice location:
  • Phone: 360-582-4605
  • Fax:
Mailing address:
  • Phone: 215-840-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number60134090
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number019611
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: