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General NPI Number Information
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NPI Number | 1174047708
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Entity Type | Individual
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Provider Name | KATHERINE BANNISTER DPT
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Gender | Female
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 2701 MAGNOLIA SPRINGS DR
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City | LEXINGTON
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State | KY
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Zip | 40511-1198
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Country | US
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Telephone | 859-410-6575
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Fax |
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Provider Business Mailing Address
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Address Line | 528 WELLINGTON GARDENS DR
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City | LEXINGTON
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State | KY
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Zip | 40503-3472
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Country | US
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Telephone | 515-577-9221
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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 | 5501017648
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 008282
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License Number State | KY
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