Provider Demographics
NPI:1467953380
Name:CHAUVIN, KATHERINE LEIGH (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEIGH
Last Name:CHAUVIN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:LEIGH
Other - Last Name:CHAUVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:135 WESLEY AVE S
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-7165
Mailing Address - Country:US
Mailing Address - Phone:253-338-6302
Mailing Address - Fax:
Practice Address - Street 1:135 WESLEY AVE S
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-7165
Practice Address - Country:US
Practice Address - Phone:253-338-6302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer