Provider Demographics
NPI:1235787862
Name:HERRIG, KATHERINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HERRIG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 E 5TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-2009
Mailing Address - Country:US
Mailing Address - Phone:563-590-3537
Mailing Address - Fax:
Practice Address - Street 1:250 5TH ST
Practice Address - Street 2:
Practice Address - City:KEYSTONE
Practice Address - State:IA
Practice Address - Zip Code:52249-9521
Practice Address - Country:US
Practice Address - Phone:319-442-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA096524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist