Basic Information
| Provider Information | |||||||||
| NPI: | 1760658173 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWEENEY | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VOSBURGH | ||||||||
| OtherFirstName: | KATHLEEN | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PHYSICAL THERAPIST | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 600 FIRST AVENUE NORTH | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067412992 | ||||||||
| FaxNumber: | 4067412994 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 FIRST AVENUE NORTH | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067412992 | ||||||||
| FaxNumber: | 4067412994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2008 | ||||||||
| LastUpdateDate: | 01/02/2017 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1328 | MT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.