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NPI Code Detail

MEDICARE: KATHRYN ELEMENTO

MEDICARE: KATHRYN ELEMENTO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT012298GA

General Provider Information

NPI Number : 1073967873
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN ELEMENTO
Provider Business Mailing Address
First Line : 1114 S WALL ST
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3062
Country : US
Telephone Number : 706-624-3000
Fax Number : 706-624-3001
Provider Business Practice Location Address
First Line : 1114 S WALL ST
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3062
Country : US
Telephone Number : 706-624-3000
Fax Number : 706-624-3001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2016
Last Update Date : 12/02/2021

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Directions to “ KATHRYN ELEMENTO ” Practice Location

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