Provider Demographics
NPI:1578821294
Name:JENKINS, KATHERINE E (PT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:E
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:E
Other - Last Name:ORBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7637 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2549
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7637 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2549
Practice Address - Country:US
Practice Address - Phone:937-898-2200
Practice Address - Fax:937-898-2234
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011813225100000X
CO12027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist