Provider Demographics
NPI:1285982561
Name:LABOVITZ, KATHARINA KRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:KATHARINA
Middle Name:KRISTINE
Last Name:LABOVITZ
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:KATHARINA
Other - Middle Name:K
Other - Last Name:TALLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:14825 N OUTER 40 RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2152
Mailing Address - Country:US
Mailing Address - Phone:636-812-1211
Mailing Address - Fax:636-812-0159
Practice Address - Street 1:14825 N OUTER 40 RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2152
Practice Address - Country:US
Practice Address - Phone:636-812-1211
Practice Address - Fax:636-812-0159
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.019545225100000X
MO2012028647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL532400020Medicare PIN
MO991509013Medicare PIN