Provider Demographics
NPI:1184150906
Name:KELLER, CATHARINE NICOLE (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:CATHARINE
Middle Name:NICOLE
Last Name:KELLER
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CATHARINE
Other - Middle Name:NICOLE
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:599 FIVE CARD DRAW
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-0811
Mailing Address - Country:US
Mailing Address - Phone:541-645-4512
Mailing Address - Fax:
Practice Address - Street 1:25 CLAREMONT ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3551
Practice Address - Country:US
Practice Address - Phone:406-752-9692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60737922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist