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Individual

CATHERINE L KNICKERBOCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3147 FERNS GLEN DR, TALLAHASSEE, FL 32309-2303
(229) 224-1282
Mailing address
3147 FERNS GLEN DR, TALLAHASSEE, FL 32309-2303
(229) 224-1282

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004553
GA
225100000X
Physical Therapist
PT4063
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000688157E
GA
05
000688157H
GA
Enumeration date
05/16/2006
Last updated
07/17/2008
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