Provider Demographics
NPI:1154024784
Name:KATS, AUSTIN EVAN (DPT)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:EVAN
Last Name:KATS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 W BROADMOOR ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2332
Mailing Address - Country:US
Mailing Address - Phone:816-863-9442
Mailing Address - Fax:
Practice Address - Street 1:304 E JACKSON ST STE 2F
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:MO
Practice Address - Zip Code:65781-9333
Practice Address - Country:US
Practice Address - Phone:417-221-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190300202251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic