Individual
CATHERINE PENN CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1690 US HIGHWAY 1 S STE A, ST AUGUSTINE, FL 32084-6024
(904) 810-2101
(904) 810-2106
Mailing address
33201 HARBOUR VISTA CIR, ST AUGUSTINE, FL 32080-5144
(904) 810-2101
(904) 810-2106
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT22844
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT22844
LICENSE
FL
Enumeration date
03/06/2007
Last updated
08/06/2007
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