Provider Demographics
NPI:1003372558
Name:LEFLER, KATHRYN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:LEFLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MIO
Mailing Address - State:MI
Mailing Address - Zip Code:48647-9310
Mailing Address - Country:US
Mailing Address - Phone:989-701-9189
Mailing Address - Fax:
Practice Address - Street 1:1200 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48859-2001
Practice Address - Country:US
Practice Address - Phone:989-701-9189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer