Provider Demographics
NPI:1699530741
Name:HARM, KATLIN ROSE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATLIN
Middle Name:ROSE
Last Name:HARM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 AVENUE F
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-1145
Mailing Address - Country:US
Mailing Address - Phone:308-529-8106
Mailing Address - Fax:
Practice Address - Street 1:1301 SAINT LUKE DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-6043
Practice Address - Country:US
Practice Address - Phone:308-529-8016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist