Provider Demographics
NPI:1295491223
Name:MCGEE, KATHRYN (LMT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:DUTENHOFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:329 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-1513
Mailing Address - Country:US
Mailing Address - Phone:970-744-9576
Mailing Address - Fax:
Practice Address - Street 1:3400 W 16TH ST UNIT R
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6862
Practice Address - Country:US
Practice Address - Phone:970-744-9576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0015043225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist