Provider Demographics
NPI:1649842253
Name:ORTMANN, KATHERINE JANE (DPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JANE
Last Name:ORTMANN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 RUTTE CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2251
Mailing Address - Country:US
Mailing Address - Phone:816-876-9199
Mailing Address - Fax:
Practice Address - Street 1:8675 W ROME BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-1291
Practice Address - Country:US
Practice Address - Phone:725-206-7929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist