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General NPI Number Information
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NPI Number | 1710497623
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Entity Type | Individual
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Provider Name | KATHERINE W MCCORKLE
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Gender | Female
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 600 RODEO DR
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City | ERLANGER
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State | KY
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Zip | 41018-1279
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Country | US
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Telephone | 513-815-5585
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Fax | 859-342-0079
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Provider Business Mailing Address
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Address Line | 6480 HARRISON AVE
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City | CINCINNATI
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State | OH
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Zip | 45247-7961
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Country | US
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Telephone | 513-354-3700
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Fax | 513-354-7651
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 007248
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT017189
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License Number State | OH
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