MEDICARE: MS. CATHERINE NOLAN PT

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	00005585	FL

General Provider Information

NPI Number	:	1578734463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE NOLAN PT

Provider Business Mailing Address
First Line	:	5424 BIRCHBEND LOOP
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6179
Country	:	US
Telephone Number	:	407-657-9891
Fax Number	:

Provider Business Practice Location Address
First Line	:	5424 BIRCHBEND LOOP
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6179
Country	:	US
Telephone Number	:	407-657-9891
Fax Number	:

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

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	03/18/2008

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