Provider Demographics
NPI:1326617168
Name:SAROSY, KATHERINE (PTMS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SAROSY
Suffix:
Gender:F
Credentials:PTMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 N 800 W
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:IN
Mailing Address - Zip Code:47943-8515
Mailing Address - Country:US
Mailing Address - Phone:219-577-2585
Mailing Address - Fax:
Practice Address - Street 1:221 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:DEMOTTE
Practice Address - State:IN
Practice Address - Zip Code:46310-8377
Practice Address - Country:US
Practice Address - Phone:219-987-9238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006783A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist