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NPI Code Detail

MEDICARE: KATELIN A KING PT, DPT, NCS, MSCS

MEDICARE:   KATELIN A KING  PT, DPT, NCS, MSCS
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
1261QP2000XPhysical Therapy Clinic/CenterPT27540FL
2225100000XPhysical TherapistPT27540FL

General Provider Information

NPI Number : 1457601999
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELIN A KING PT, DPT, NCS, MSCS
Provider Business Mailing Address
First Line : 11375 BIG BEND RD
Second Line :
City : RIVERVIEW
State : FL
Zip : 33579-7183
Country : US
Telephone Number : 813-805-8167
Fax Number :
Provider Business Practice Location Address
First Line : 11375 BIG BEND RD
Second Line :
City : RIVERVIEW
State : FL
Zip : 33579-7183
Country : US
Telephone Number : 813-805-8167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2012
Last Update Date : 07/23/2020

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1649376690 — STEPHANIE M BRIDWELL MSPT, CSCS
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1144542341 — MS. MANDY SUE HUSTER PT, DPT
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Directions to “ KATELIN A KING PT, DPT, NCS, MSCS” Practice Location

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