Provider Demographics
NPI:1912329640
Name:STALOCH, CATHERINE ELIZABETH (PT)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:STALOCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:225 N 7TH ST
Mailing Address - Street 2:SEVENTH AND THAYER CLINIC OUTPATIENT PHYSICAL THERAPY
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4417
Mailing Address - Country:US
Mailing Address - Phone:701-323-8933
Mailing Address - Fax:
Practice Address - Street 1:225 N 7TH ST
Practice Address - Street 2:SEVENTH AND THAYER CLINIC OUTPATIENT PHYSICAL THERAPY
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4417
Practice Address - Country:US
Practice Address - Phone:701-323-8933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14102251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology