Provider Demographics
NPI:1083927099
Name:KATZ, JEFF (CO)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 N CHRISMAN RD
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-9314
Mailing Address - Country:US
Mailing Address - Phone:541-385-8884
Mailing Address - Fax:541-322-9705
Practice Address - Street 1:2200 NE NEFF RD
Practice Address - Street 2:SUITE 306
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4283
Practice Address - Country:US
Practice Address - Phone:541-385-8884
Practice Address - Fax:541-322-9705
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter