Provider Demographics
NPI:1740575257
Name:HOSKING, KATHRYN J (PT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:J
Last Name:HOSKING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 COUNTY ROAD HQ
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-8855
Mailing Address - Country:US
Mailing Address - Phone:906-225-5570
Mailing Address - Fax:906-225-5572
Practice Address - Street 1:700 RIVER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3466
Practice Address - Country:US
Practice Address - Phone:906-776-9003
Practice Address - Fax:906-776-9063
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225100000X
MI5501016529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI832070039Medicare PIN