Provider Demographics
NPI:1932886215
Name:DAMELE, KATIE EILEEN (DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:EILEEN
Last Name:DAMELE
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:HC 62 BOX 62191
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:NV
Mailing Address - Zip Code:89316-9601
Mailing Address - Country:US
Mailing Address - Phone:775-237-9280
Mailing Address - Fax:
Practice Address - Street 1:890 11TH STREET
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:NV
Practice Address - Zip Code:89316
Practice Address - Country:US
Practice Address - Phone:775-237-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist