Provider Demographics
NPI:1689049819
Name:WADSWORTH, KATHERINE RUTH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:RUTH
Last Name:WADSWORTH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:RUTH
Other - Last Name:RHAESA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9040 W WESTLAWN ST
Mailing Address - Street 2:APARTMENT 803
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5320
Mailing Address - Country:US
Mailing Address - Phone:620-664-7142
Mailing Address - Fax:
Practice Address - Street 1:10333 E 21ST ST N
Practice Address - Street 2:SUITE #406
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3543
Practice Address - Country:US
Practice Address - Phone:316-630-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist