Provider Demographics
NPI:1205191574
Name:ANDERS, KATERI LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:KATERI
Middle Name:LYNN
Last Name:ANDERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATERI
Other - Middle Name:LYNN
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:237 JOHNS ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1555
Mailing Address - Country:US
Mailing Address - Phone:814-539-2050
Mailing Address - Fax:
Practice Address - Street 1:237 JOHNS ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1555
Practice Address - Country:US
Practice Address - Phone:814-539-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist