Individual
KATHRYN CORINNE NEWSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1718 SAINT JULIAN PL, COLUMBIA, SC 29204-2410
(038) 771-0370
(803) 771-0371
Mailing address
141 ATRIUM WAY, COLUMBIA, SC 29223-6301
(038) 771-0370
(803) 771-0371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6899
SC
225100000X
Physical Therapist
PTL.0012005
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000142370
—
CO
Enumeration date
04/23/2014
Last updated
10/04/2021
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