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Individual

KATHERINE HEFNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
4900 DOMINION BLVD STE B, GLEN ALLEN, VA 23060-6773
(804) 747-4673
Mailing address
4900 DOMINION BLVD STE B, GLEN ALLEN, VA 23060-6773

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305212310
VA
225100000X
Physical Therapist
9127
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2305212310
VIRGINIA STATE BOARD OF PHYSICAL THERAPY
VA
01
9127
SOUTH CAROLINA STATE BOARD OF PHYSICAL THERAPY
SC
Enumeration date
01/14/2020
Last updated
01/14/2020
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