Provider Demographics
NPI:1407322951
Name:SAULTER, KATELYN M (LAT, ATC)
Entity Type:Individual
Prefix:MISS
First Name:KATELYN
Middle Name:M
Last Name:SAULTER
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N HOPKINS ST
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1818
Mailing Address - Country:US
Mailing Address - Phone:814-203-0833
Mailing Address - Fax:
Practice Address - Street 1:520 N HOPKINS ST
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1818
Practice Address - Country:US
Practice Address - Phone:814-203-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0068832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer