Provider Demographics
NPI:1598331852
Name:VOTH, KATIE MARIE (ATC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:VOTH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 S 144TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5243
Mailing Address - Country:US
Mailing Address - Phone:402-609-3206
Mailing Address - Fax:402-637-0846
Practice Address - Street 1:2725 S 144TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5243
Practice Address - Country:US
Practice Address - Phone:402-609-3206
Practice Address - Fax:402-637-0846
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer