Provider Demographics
NPI:1972735686
Name:KOHLER, CATHERINE JANE PRIDDY (DPT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JANE PRIDDY
Last Name:KOHLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:JANE
Other - Last Name:PRIDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2819 GREAT NORTHERN LOOP STE 300
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1750
Mailing Address - Country:US
Mailing Address - Phone:406-317-1121
Mailing Address - Fax:406-317-1875
Practice Address - Street 1:2819 GREAT NORTHERN LOOP STE 300
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1750
Practice Address - Country:US
Practice Address - Phone:406-317-1121
Practice Address - Fax:406-317-1875
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6055225100000X
MT2480225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR150653Medicare PIN