Provider Demographics
NPI:1184150096
Name:AVIS, KATHRYN LOUISE (DPT, ATC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LOUISE
Last Name:AVIS
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LOUISE
Other - Last Name:HARVEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, ATC
Mailing Address - Street 1:7205 E CHANDLER AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4332
Mailing Address - Country:US
Mailing Address - Phone:423-307-2986
Mailing Address - Fax:
Practice Address - Street 1:7205 E CHANDLER AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4332
Practice Address - Country:US
Practice Address - Phone:423-307-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IN05012535A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist