Katherine Dacosta

NPI #1790964534 in Douglasville, Georgia

Provider Information

NPI Number: 1790964534
Entity Type: Individual
Name: Katherine Dacosta
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Oct 29, 2007
Last Updated: Oct 29, 2007

Practice Location

Address: 4586 TIMBER RIDGE DR STE 160
City: Douglasville
State: Georgia
ZIP Code: 30135-7513
Phone: (770) 949-0558

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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