Individual
MS. KATHERINE M. BAGNATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, OTC, CEAS
Contact information
Practice address
5825 CARNEGIE BLVD, CHARLOTTE, NC 28209-4633
(609) 377-7310
Mailing address
5825 CARNEGIE BLVD, CHARLOTTE, NC 28209-4633
(609) 377-7310
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
25MT00056400
NJ
2255A2300X
Athletic Trainer
Primary
LAT-2924
NC
246Z00000X
Other Specialist/Technologist
25MT00056400
NJ
Other
Enumeration date
06/29/2006
Last updated
03/01/2017
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