Provider Demographics
NPI:1659421667
Name:PITTS, DENISE CATHERINE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:CATHERINE
Last Name:PITTS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E LASALLE AVE
Mailing Address - Street 2:
Mailing Address - City:SO BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617
Mailing Address - Country:US
Mailing Address - Phone:574-472-6951
Mailing Address - Fax:574-472-6294
Practice Address - Street 1:801 E LASALLE AVE
Practice Address - Street 2:
Practice Address - City:SO BEND
Practice Address - State:IN
Practice Address - Zip Code:46617
Practice Address - Country:US
Practice Address - Phone:574-472-6951
Practice Address - Fax:574-472-6294
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005084A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist