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General NPI Number Information
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NPI Number | 1235518069
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Entity Type | Individual
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Provider Name | KATHERINE BENNETT DPT
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Gender | Female
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 1911 TELFAIR WAY
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City | CHARLESTON
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State | SC
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Zip | 29412-2373
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Country | US
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Telephone | 864-941-7052
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 TELFAIR WAY
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City | CHARLESTON
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State | SC
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Zip | 29412-2373
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 7037
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License Number State | SC
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