Provider Demographics
NPI:1487925251
Name:CROXTON, KATHERINE ELAINE (DPT, ATC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELAINE
Last Name:CROXTON
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 TRIFECTA PL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-4958
Mailing Address - Country:US
Mailing Address - Phone:304-728-9090
Mailing Address - Fax:304-728-9087
Practice Address - Street 1:46 TRIFECTA PL
Practice Address - Street 2:SUITE 104
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4958
Practice Address - Country:US
Practice Address - Phone:304-728-9090
Practice Address - Fax:304-728-9087
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT 003009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist