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General NPI Number Information
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NPI Number | 1306226329
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Entity Type | Individual
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Provider Name | KATHLEEN RESS PT
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Gender | Female
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 16 TUCCAMIRGAN ROAD
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City | FLEMINGTON
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State | NJ
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Zip | 08822-2182
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Country | US
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Telephone | 908-581-4499
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Fax |
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Provider Business Mailing Address
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Address Line | 1059 MUSTANG DRIVE
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City | CLINTON
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State | AR
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Zip | 72031-5919
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Country | US
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Telephone | 908-581-4499
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | PT 3962
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License Number State | AR
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