Provider Demographics
NPI:1437556263
Name:LEIST, KATHERINE GUTHRIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:GUTHRIE
Last Name:LEIST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-777-6236
Mailing Address - Fax:
Practice Address - Street 1:115 VILLAGE SQ STE E
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-6059
Practice Address - Country:US
Practice Address - Phone:601-829-0505
Practice Address - Fax:601-829-0506
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024093225100000X
WVPT003421225100000X
MSPT5848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist