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General NPI Number Information
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NPI Number | 1134528540
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Entity Type | Individual
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Provider Name | KATHERINE NICOLE DAVEY DPT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 1555 S HARDING ST BLDG K144
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City | INDIANAPOLIS
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State | IN
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Zip | 46221-1873
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Country | US
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Telephone | 317-277-6004
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Fax | 317-227-8935
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone | 630-296-2222
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Fax | 630-759-6108
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05010861A
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License Number State | IN
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