Provider Demographics
NPI:1447606306
Name:WESENBERG, KATHRYN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:WESENBERG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:BARDENWERPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4660 PINERY POINT CT
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:WI
Mailing Address - Zip Code:54443-9685
Mailing Address - Country:US
Mailing Address - Phone:262-442-2533
Mailing Address - Fax:
Practice Address - Street 1:4660 PINERY POINT CT
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:WI
Practice Address - Zip Code:54443-9685
Practice Address - Country:US
Practice Address - Phone:262-442-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209638225100000X
FLPT31144225100000X
WI13439-24225100000X
WI13439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist