Provider Demographics
NPI:1366051609
Name:KASS, CATELIN INFANTE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CATELIN
Middle Name:INFANTE
Last Name:KASS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 RELICT DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-6736
Mailing Address - Country:US
Mailing Address - Phone:813-992-1370
Mailing Address - Fax:
Practice Address - Street 1:4515 E CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3915
Practice Address - Country:US
Practice Address - Phone:316-260-6869
Practice Address - Fax:316-260-6872
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16583225100000X
KS11-07175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist