Provider Demographics
NPI:1871961383
Name:BAIN, KATHERINE ANN (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANN
Last Name:BAIN
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-5747
Mailing Address - Country:US
Mailing Address - Phone:757-408-5685
Mailing Address - Fax:
Practice Address - Street 1:409 WOODBRIDGE DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5747
Practice Address - Country:US
Practice Address - Phone:757-408-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052098552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic