Provider Demographics
NPI:1265455828
Name:MAUSHART, KATHERINE SUE (PTA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SUE
Last Name:MAUSHART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1582 CREEKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1794
Mailing Address - Country:US
Mailing Address - Phone:513-943-0058
Mailing Address - Fax:
Practice Address - Street 1:6900 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2910
Practice Address - Country:US
Practice Address - Phone:513-231-4561
Practice Address - Fax:513-624-3730
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04228225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant