Provider Demographics
NPI:1093745507
Name:MONZYK, KATHLEEN M (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:M
Last Name:MONZYK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12539 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6311
Mailing Address - Country:US
Mailing Address - Phone:314-205-2006
Mailing Address - Fax:142-052-2413
Practice Address - Street 1:12539 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6311
Practice Address - Country:US
Practice Address - Phone:314-205-2006
Practice Address - Fax:142-052-2413
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1178282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic