Provider Demographics
NPI:1962666255
Name:CHASE, CATHY (CA)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2045 ATWOOD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-6622
Mailing Address - Country:US
Mailing Address - Phone:608-256-5080
Mailing Address - Fax:608-661-0489
Practice Address - Street 1:2045 ATWOOD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-6622
Practice Address - Country:US
Practice Address - Phone:608-256-5080
Practice Address - Fax:608-661-0489
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI330-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist