MEDICARE: MRS. KATHY A TEACHOUT-SEMBER 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	010791-1	NY
2	2251P0200X	Pediatric Physical Therapist	5422	NC

General Provider Information

NPI Number	:	1669501607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHY A TEACHOUT-SEMBER PT

Provider Business Mailing Address
First Line	:	2517 PINE TREE LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-6579
Country	:	US
Telephone Number	:	315-427-0506
Fax Number	:

Provider Business Practice Location Address
First Line	:	627 E WASHINGTON ST
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1737
Country	:	US
Telephone Number	:	252-382-9604
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	08/30/2023

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