Provider Demographics
NPI:1962483743
Name:SKINNER, KATE M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:M
Last Name:SKINNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2819 GREAT NORTHERN LOOP
Mailing Address - Street 2:STE 300
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1750
Mailing Address - Country:US
Mailing Address - Phone:406-317-1121
Mailing Address - Fax:
Practice Address - Street 1:2819 GREAT NORTHERN LOOP
Practice Address - Street 2:STE 300
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1750
Practice Address - Country:US
Practice Address - Phone:406-317-1121
Practice Address - Fax:406-317-1875
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT604550OtherBCBS