Provider Demographics
NPI:1518324367
Name:KAHLER, KATHERINE SARAH (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SARAH
Last Name:KAHLER
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:S
Other - Last Name:NIEBUHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, ATC
Mailing Address - Street 1:PO BOX 2758
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2758
Mailing Address - Country:US
Mailing Address - Phone:319-235-5390
Mailing Address - Fax:319-235-5607
Practice Address - Street 1:2351 HUDSON RD
Practice Address - Street 2:SUITE 164
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50614-0001
Practice Address - Country:US
Practice Address - Phone:319-273-5265
Practice Address - Fax:319-273-5266
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1518324367Medicaid