Individual
KATHERINE KIPOURAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5275
MA
225100000X
Physical Therapist
PT25401
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468801
TUFTS PROVIDER ID
MA
01
—
Y66507
BLUE CROSS PROVIDER ID
MA
Enumeration date
10/04/2006
Last updated
10/07/2015
Update your record
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