Individual
MRS. KATHRYN C PECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, CMP
Contact information
Practice address
15300 E WEST RD, MIDLOTHIAN, VA 23114-3372
(804) 320-4064
(804) 320-4052
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 968-1803
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305213474
VA
225100000X
Physical Therapist
Primary
PT8647
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174185
LABOR & INDUSTRIES
WA
05
—
8373581
—
WA
Enumeration date
09/13/2006
Last updated
05/14/2026
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