Doctor Name: | MRS. KATIE TAYLOR ETHRIDGE |
NPI Number: | 1518183508 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MOT, OTRL |
License Number: | 1310 |
Business Practice Address: | 179 Station Place Way Suite 100 Hurricane, WV - 255268747 |
Business Phone Number: | 3047606300 |
Business Fax Number: | 3042015123 |
Mailing Address: | Po Box 450, SCOTT DEPOT |
State: | WV |
Postal Code: | 255600450 |
Phone Number: | 3047606300 |
Fax Number: | 3042015123 |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 05/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1310 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |