Home > Massachusetts

KATHERINE SHAO

NPI: 1003149774

Physical Therapist
Active Status:
INACTIVE
Gender:
FEMALE
Estimated Age:
N/A
Medical School:
UNLISTED
Primary Organization:
NONE
Last Updated Date:
09-13-2024

Primary Practice Location

Unknown Facility
1115 W CHESTNUT ST
BROCKTON, MA 07501
(508) 580-4691

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NPPES NPI Registry Data

View this provider on cms.gov

Name:
KATHERINE SHAO

NPI

1003149774

Gender Code

F

Enumeration Date

09/14/2009

NPPES Last Update Date

10/14/2014

Is Sole Proprietor

N

Taxonomy Code 1

225100000X

Taxonomy Code 2

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Taxonomy Code 3

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Taxonomy Code 4

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Taxonomy Code 5

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Provider License Number 1

18764

Provider License State Code 1

MA

Provider License Number 2

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Provider License State Code 2

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Provider License Number 3

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Provider License State Code 3

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Provider License Number 4

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Provider License State Code 4

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Provider License Number 5

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Provider License State Code 5

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Business Mailing Address

23 JEFFREY CIR,
BEDFORD, MA 17301

Business Telephone

(617) 921-8309

Business Fax

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Practice Address

1115 W CHESTNUT ST,
BROCKTON, MA 23017501

Business Telephone

(508) 580-4691

Business Fax

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