Individual ProviderKatie Autumn ThurstonMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4598 Broad St, Virginia Beach, VA 23462-2839(757) 937-3558PECOS EnrollmentBased on the most recent information from CMS, provider Katie Autumn Thurston does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1821759515Provider TypeIndividualFull NameThurston, Katie AutumnGenderFemaleSole ProprietorNoEnumeration Date1/4/2022Last Updated5/22/2023Contact InformationPractice LocationPractice Address4598 Broad St, Virginia Beach, VA 23462-2839Phone(757) 937-3558FaxUnlisted FaxMailing LocationMailing Address4598 Broad St Ste 100, Virginia Beach, VA 23462-2839Phone(757) 937-3558Fax(757) 937-3979Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense0019018282Virginia