Provider Demographics
NPI:1932683786
Name:TSCHIRHART, KATIE (PT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:TSCHIRHART
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 1:1660 HASLETT RD STE 4
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8469
Mailing Address - Country:US
Mailing Address - Phone:517-339-4050
Mailing Address - Fax:
Practice Address - Street 1:1660 HASLETT RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8469
Practice Address - Country:US
Practice Address - Phone:517-339-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist