Provider Demographics
NPI:1598154304
Name:PITRE, KAITLYN JUNELLE
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:JUNELLE
Last Name:PITRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 BAUER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604
Mailing Address - Country:US
Mailing Address - Phone:989-284-3619
Mailing Address - Fax:
Practice Address - Street 1:3375 BAUER DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2238
Practice Address - Country:US
Practice Address - Phone:989-284-3619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer