Provider Demographics
NPI:1295553303
Name:ROBINSON, KATIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 FALLING STAR LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5629
Mailing Address - Country:US
Mailing Address - Phone:931-307-9787
Mailing Address - Fax:
Practice Address - Street 1:3925 MAYNARDVILLE HWY STE 1
Practice Address - Street 2:
Practice Address - City:MAYNARDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37807-3552
Practice Address - Country:US
Practice Address - Phone:865-333-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist