Katherine Dacosta

NPI 1790964534 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1790964534
Gender Female
Enumeration Date 10/29/2007
Last Updated 10/29/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
4586 TIMBER RIDGE DR STE 160
DOUGLASVILLE GA, 30135-7513, US
Phone (770) 949-0558
Fax
Business Location
4586 TIMBER RIDGE DR STE 160
DOUGLASVILLE GA, 30135-7513, US
Phone (770) 949-0558
Fax
Toxanomy
Taxonomy Code 225200000X
License State Georgia
License Number 1853
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According to our database, Katherine Dacosta NPI is 1790964534, taxonomy code is 225200000X and license number is 1853, license state is located at Georgia. Katherine Dacosta physically located at 4586 Timber Ridge Dr Ste 160, Douglasville GA, 30135-7513. NPI Number Katherine Dacosta has the Individual type.

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1790964534 NPI number is provided on an as is basis without warranty of any kind. 1790964534 is maintained by the National Plan & Provider Enumeration System. The contents of Katherine Dacosta are for informational purposes only.