Provider Demographics
NPI:1689725830
Name:LEFRID, KATHERINE (PT, DPT, LMT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:LEFRID
Suffix:
Gender:F
Credentials:PT, DPT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 DEER HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-8799
Mailing Address - Country:US
Mailing Address - Phone:321-278-5906
Mailing Address - Fax:
Practice Address - Street 1:854 WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7143
Practice Address - Country:US
Practice Address - Phone:616-392-9430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48828225700000X
MI5501019854225100000X
FLPT20926225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist