Provider Demographics
NPI:1679074587
Name:CATLIN, ALEX SEAN (DPT)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:SEAN
Last Name:CATLIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:MI
Mailing Address - Zip Code:48847-1507
Mailing Address - Country:US
Mailing Address - Phone:989-875-4193
Mailing Address - Fax:989-875-3807
Practice Address - Street 1:509 E CENTER ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:MI
Practice Address - Zip Code:48847-1507
Practice Address - Country:US
Practice Address - Phone:989-875-4193
Practice Address - Fax:989-875-3807
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist