Individual
KATHERINE J MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1108 N MAIN ST, CEDARTOWN, GA 30125-2039
(706) 236-2774
(706) 802-1408
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 236-2774
(706) 802-1408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005725
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253622694C
—
GA
Enumeration date
06/24/2008
Last updated
05/16/2011
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