Provider Demographics
NPI:1407254014
Name:FRITZ, CATHLEEN
Entity Type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CATHLEEN
Other - Middle Name:
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:3377 RIVERBEND DR
Mailing Address - Street 2:3RD FLOOR RIVERBEND PAVILION
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8803
Mailing Address - Country:US
Mailing Address - Phone:541-222-6360
Mailing Address - Fax:541-222-6218
Practice Address - Street 1:3377 RIVERBEND DR
Practice Address - Street 2:3RD FLOOR RIVERBEND PAVILION
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8803
Practice Address - Country:US
Practice Address - Phone:541-222-6360
Practice Address - Fax:541-222-6218
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist