MEDICARE: DR. KATHERINE ZETKULIC 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	2305215861	VA

General Provider Information

NPI Number	:	1790463222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE ZETKULIC DPT

Provider Business Mailing Address
First Line	:	9325 MIDLOTHIAN TPKE
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4943
Country	:	US
Telephone Number	:	703-490-3223
Fax Number	:

Provider Business Practice Location Address
First Line	:	6715 LITTLE RIVER TPKE STE 200
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3546
Country	:	US
Telephone Number	:	703-879-2479
Fax Number	:	703-879-2803

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

Provider Enumeration Date	:	07/05/2023
Last Update Date	:	04/15/2026

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