Individual
KATHRYN DEJESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 633-8640
Mailing address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 633-8640
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12196
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018TE
BLUE CROSS
NC
Enumeration date
09/29/2009
Last updated
09/29/2009
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