Individual
KATIE IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2050 OAK TREE RD, EDISON, NJ 08820-2012
(732) 548-7610
Mailing address
PO BOX 1014, 1180 RARITAN ROAD, CLARK, NJ 07066-1014
(732) 855-9751
(732) 855-9755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
NY027489
NY
2251X0800X
Orthopedic Physical Therapist
Primary
40QA01305900
NJ
Other
Enumeration date
03/08/2006
Last updated
02/01/2012
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