Basic Information
| Provider Information | |||||||||
| NPI: | 1811907751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVEY | ||||||||
| FirstName: | KATHERINE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1055 6TH AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503142607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156438672 | ||||||||
| FaxNumber: | 5156432784 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E 1ST ST | ||||||||
| Address2: | SUITE W270 | ||||||||
| City: | ANKENY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500212077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156437555 | ||||||||
| FaxNumber: | 5156437560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 03216 | IA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.