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General NPI Number Information
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NPI Number | 1144722489
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Entity Type | Individual
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Provider Name | KATHERINE RILEY SHORE PT, DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 497 OLDE WATERFORD WAY STE 102
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City | BELVILLE
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State | NC
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Zip | 28451-4183
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Country | US
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Telephone | 910-444-1548
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 OLEANDER DR STE 211
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City | WILMINGTON
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State | NC
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Zip | 28403-4722
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Country | US
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Telephone |
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Fax |
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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 | P24079
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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