Individual
KATHRYN LEAH KNODT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11774 DAWKINS RIDGE LN, BRISTOW, VA 20136-6185
(703) 408-0344
Mailing address
11774 DAWKINS RIDGE LN, BRISTOW, VA 20136-6185
(703) 408-0344
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605109
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2306605109
PHYSICAL THERAPY ASSISTANT
VA
Enumeration date
07/01/2019
Last updated
07/01/2019
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