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General NPI Number Information
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NPI Number | 1356051635
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Entity Type | Individual
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Provider Name | KATHERINE ANN MASON
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Gender | Female
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 15425 MANCHESTER RD STE 28
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City | BALLWIN
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State | MO
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Zip | 63011-3077
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Country | US
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Telephone | 636-220-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 DODDRIDGE AVE
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-1387
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Country | US
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Telephone | 314-497-2957
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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 |
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License Number State |
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