Provider Demographics
NPI:1023673860
Name:SCHUELKE, KATIE ANN (DPT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:SCHUELKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ANN
Other - Last Name:DOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14476 HACKAMORE RANCH ROAD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57649
Mailing Address - Country:US
Mailing Address - Phone:605-641-0622
Mailing Address - Fax:
Practice Address - Street 1:520 N CANYON ST
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2320
Practice Address - Country:US
Practice Address - Phone:605-642-7996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist