Basic Information
Provider Information
NPI: 1417197336
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REPLOGLE
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 280
Address2:  
City: MINDEN
State: NV
PostalCode: 894230280
CountryCode: US
TelephoneNumber: 7757837606
FaxNumber: 7757837605
Practice Location
Address1: 1667 LUCERNE ST STE B
Address2:  
City: MINDEN
State: NV
PostalCode: 894234360
CountryCode: US
TelephoneNumber: 7757837606
FaxNumber: 7757837605
Other Information
ProviderEnumerationDate: 03/05/2009
LastUpdateDate: 03/05/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800X0177NVY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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