Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 5024 | AZ |
N | 2251N0400X | Physical Therapist - Neurology | 5024 | AZ |
N | 2251X0800X | Physical Therapist - Orthopedic | 5024 | AZ |
NPI | 1528196680 |
---|---|
Provider Name | Ms. Kathryn Elizabeth Kaczor |
First Address | Sierra Vista, AZ 85650-8921 |
Second Address | Sierra Vista, AZ 85650-8921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 08/07/2007 |