Provider Demographics
NPI:1639695745
Name:GHESS, KATI JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATI
Middle Name:JEAN
Last Name:GHESS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KATI
Other - Middle Name:JEAN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54437-0217
Mailing Address - Country:US
Mailing Address - Phone:715-267-7000
Mailing Address - Fax:
Practice Address - Street 1:124 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:WI
Practice Address - Zip Code:54437-9419
Practice Address - Country:US
Practice Address - Phone:715-575-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5297-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor