Individual
MRS. CATHERINE MARIE KOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
202 W MOHAWK DR, TOMAHAWK, WI 54487-2215
(715) 453-7600
(715) 453-6403
Mailing address
1255 E KING RD, TOMAHAWK, WI 54487-2004
(715) 453-4646
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
381-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40336300
—
WI
Enumeration date
11/13/2006
Last updated
07/09/2007
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