Provider Demographics
NPI:1922498534
Name:ALTMANN, KATIE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:ALTMANN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:CALVERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 WOODDUCK RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2233
Mailing Address - Country:US
Mailing Address - Phone:812-204-9121
Mailing Address - Fax:
Practice Address - Street 1:7711 MICHAEL LN
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8004
Practice Address - Country:US
Practice Address - Phone:812-204-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X, 390200000X
VA01260029212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program