Provider Demographics
NPI:1508097213
Name:KRAFT, KATHRYN A (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:KRAFT
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:WI
Mailing Address - Zip Code:53555-1320
Mailing Address - Country:US
Mailing Address - Phone:608-327-9681
Mailing Address - Fax:
Practice Address - Street 1:311 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:WI
Practice Address - Zip Code:53555-1320
Practice Address - Country:US
Practice Address - Phone:608-327-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCP043706T225100000X
WI10956-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist