Provider Demographics
NPI:1396387577
Name:CHAPMAN, KATELYN MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MARIE
Other - Last Name:PLOURDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:163 VAN BUREN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-3567
Mailing Address - Country:US
Mailing Address - Phone:207-498-1618
Mailing Address - Fax:207-498-1653
Practice Address - Street 1:163 VAN BUREN RD
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-3567
Practice Address - Country:US
Practice Address - Phone:207-498-1618
Practice Address - Fax:207-498-1653
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist