Individual
KATHERINE SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3243 W 3RD ST, BLOOMINGTON, IN 47404
(812) 668-1880
(812) 668-1881
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011908A
IN
225100000X
Physical Therapist
08864
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174173
—
LA
Enumeration date
08/12/2014
Last updated
08/24/2018
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