=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184348542
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHRYN MAE BRADLEY MACHON DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2022
-----------------------------------------------------
Last Update Date | 10/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 135 JACK BRANCH DRIE
-----------------------------------------------------
City | BOONE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28608-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-398-4539
-----------------------------------------------------
Fax | 828-398-4539
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 135 JACK BRANCH DRIVE
-----------------------------------------------------
City | BOONE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28608-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-266-0030
-----------------------------------------------------
Fax | 828-398-4539
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | P20274
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------