Provider Demographics
NPI:1730147166
Name:KATKO, KARA (LAC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:KATKO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 FALLS OF NEUSE RD
Mailing Address - Street 2:STE 35
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6877
Mailing Address - Country:US
Mailing Address - Phone:408-702-8872
Mailing Address - Fax:
Practice Address - Street 1:6325 FALLS OF NEUSE RD
Practice Address - Street 2:STE 35
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6877
Practice Address - Country:US
Practice Address - Phone:408-702-8872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10131171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist