Provider Demographics
NPI:1700669934
Name:DAANE, KATHRYN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:DAANE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:SOBOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:4000 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083-2245
Mailing Address - Country:US
Mailing Address - Phone:920-459-9090
Mailing Address - Fax:920-459-7426
Practice Address - Street 1:4000 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53083-2245
Practice Address - Country:US
Practice Address - Phone:920-459-9090
Practice Address - Fax:920-459-7426
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17231-146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor