Provider Demographics
NPI:1992034912
Name:COUTURE, KATIE M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:M
Last Name:COUTURE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 N TRIANGLE DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7505
Mailing Address - Country:US
Mailing Address - Phone:617-429-4597
Mailing Address - Fax:
Practice Address - Street 1:30 PLAYSTEAD RD
Practice Address - Street 2:SUITE #1
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2125
Practice Address - Country:US
Practice Address - Phone:617-306-6519
Practice Address - Fax:617-224-4672
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist