Provider Demographics
NPI:1144008566
Name:MATHIEU, KATHRYN (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MATHIEU
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SPRING RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4707
Mailing Address - Country:US
Mailing Address - Phone:615-815-0000
Mailing Address - Fax:
Practice Address - Street 1:8081 WALNUT HILL LN # 1000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4313
Practice Address - Country:US
Practice Address - Phone:214-750-1207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist