Provider Demographics
NPI:1962615294
Name:DEOPERE, CATHERINE TIFFINEY (PT)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:TIFFINEY
Last Name:DEOPERE
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 1:2024 WINSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2534
Mailing Address - Country:US
Mailing Address - Phone:270-402-4546
Mailing Address - Fax:
Practice Address - Street 1:2024 WINSTON AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2534
Practice Address - Country:US
Practice Address - Phone:270-402-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist