Provider Demographics
NPI:1124467303
Name:DAY-CAREY, KATHLEEN ANN (LMT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:DAY-CAREY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17086 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GALESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54630-8048
Mailing Address - Country:US
Mailing Address - Phone:608-582-2160
Mailing Address - Fax:
Practice Address - Street 1:17086 N 4TH ST
Practice Address - Street 2:
Practice Address - City:GALESVILLE
Practice Address - State:WI
Practice Address - Zip Code:54630-8048
Practice Address - Country:US
Practice Address - Phone:608-582-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10814-146171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor