Provider Demographics
NPI:1396013025
Name:LOKEN, KATIE A (MPT)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:A
Last Name:LOKEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-4144
Mailing Address - Country:US
Mailing Address - Phone:920-738-0200
Mailing Address - Fax:920-738-0383
Practice Address - Street 1:2200 S KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4144
Practice Address - Country:US
Practice Address - Phone:920-738-0200
Practice Address - Fax:920-738-0383
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9202-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist