Provider Demographics
NPI:1285075762
Name:KIRACOFE, CATHERINE (PT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:KIRACOFE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:PANDORA
Mailing Address - State:OH
Mailing Address - Zip Code:45877-0282
Mailing Address - Country:US
Mailing Address - Phone:419-852-3073
Mailing Address - Fax:
Practice Address - Street 1:5531 CHAPPELL CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5226
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.013340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist