Provider Demographics
NPI:1609224591
Name:DWOZAN, KATHERINE LYNN (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:DWOZAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:3480 KEITH BRIDGE RD
Practice Address - Street 2:STE C2
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5568
Practice Address - Country:US
Practice Address - Phone:678-455-8773
Practice Address - Fax:678-455-8775
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist