Provider Demographics
NPI:1558921163
Name:LEACH, KATHERINE S (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:LEACH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:S
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3276
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47731-3276
Mailing Address - Country:US
Mailing Address - Phone:812-473-0181
Mailing Address - Fax:812-473-5822
Practice Address - Street 1:412 E 2ND ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4204
Practice Address - Country:US
Practice Address - Phone:270-926-8145
Practice Address - Fax:270-926-8147
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist