Provider Demographics
NPI:1609855519
Name:HUMPHREY, KATHERINE P (PT)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:P
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:E
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 971
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MT
Mailing Address - Zip Code:59644-0971
Mailing Address - Country:US
Mailing Address - Phone:406-544-5598
Mailing Address - Fax:406-792-8043
Practice Address - Street 1:128 US HIGHWAY 12 E
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MT
Practice Address - Zip Code:59644-9702
Practice Address - Country:US
Practice Address - Phone:406-544-5598
Practice Address - Fax:406-792-8043
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2014171W00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171W00000XOther Service ProvidersContractor