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General NPI Number Information
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NPI Number | 1992432561
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Entity Type | Individual
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Provider Name | KATHERINE MICHELLE VALENCIA CALDERON DPT
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Gender | Female
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 3850 HOLCOMB BRIDGE RD STE 245
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City | NORCROSS
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State | GA
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Zip | 30092-5220
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Country | US
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Telephone | 770-710-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 178 KING ARTHUR DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4754
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Country | US
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Telephone | 404-723-5793
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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 |
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License Number State |
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