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Mrs. Katie Taylor Ethridge, MOT,OTRL
Specialist in Hurricane, West Virginia
NPI 1518183508

Katie Taylor Ethridge is a Specialist based in Scott Depot, WV. Katie Taylor Ethridge practices in Hurricane, WV and has the professional credentials of MOT,OTRL. The NPI Number for Katie Taylor Ethridge is 1518183508 and holds a License No. 1310 (West Virginia).

The current practice location address for Katie Taylor Ethridge is 179 Station Place Way, Hurricane, WV and can be reached out via phone at 304-760-6300 and via fax at 304-201-5123.

Location: 179 Station Place Way, Hurricane, WV, 25560-0450
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518183508
Provider Name
Katie Taylor Ethridge
Credential
MOT,OTRL
Provider Entity Type
Individual
Gender
Female
Address
179 Station Place Way, Hurricane, WV, 25560-0450
Phone Number
304-760-6300
Fax Number
304-201-5123
Provider Enumeration Date
04/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
JL75-0029 01 DC BCBS PROVIDER NUMBER
890362-01 01 MD BCBC PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
179 Station Place Way
City
Hurricane
State
West Virginia
Zip
25526-8747
Phone Number
304-760-6300
Fax Number
304-201-5123
person
Provider Business Mailing Address Details
Address
179 Station Place Way
City
Hurricane
State
West Virginia
Zip
25526-8747
Phone Number
304-760-6300
Fax Number
304-201-5123
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1310 (West Virginia)
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.
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