Provider Demographics
NPI:1033751300
Name:WASON, KATHRYN R (DPT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:R
Last Name:WASON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:285 HYDRAULIC RIDGE ROAD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8126
Mailing Address - Country:US
Mailing Address - Phone:434-817-0980
Mailing Address - Fax:434-817-0985
Practice Address - Street 1:285 HYDRAULIC RIDGE ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8126
Practice Address - Country:US
Practice Address - Phone:434-817-0980
Practice Address - Fax:434-817-0985
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA23052120742251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports