MEDICARE: KATIE GREER DPT

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
1	225100000X	Physical Therapist	2305205929	VA

General Provider Information

NPI Number	:	1275768913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE GREER DPT

Provider Business Mailing Address
First Line	:	5712 CLEVELAND ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1779
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5712 CLEVELAND ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1779
Country	:	US
Telephone Number	:	757-490-4802
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	05/08/2023

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