Provider Demographics
NPI:1487701983
Name:KLEINHENZ, CATHY ANN (PT)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:ANN
Last Name:KLEINHENZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 STILLWATER DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7164
Mailing Address - Country:US
Mailing Address - Phone:928-442-0005
Mailing Address - Fax:928-442-0660
Practice Address - Street 1:3117 STILLWATER DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7164
Practice Address - Country:US
Practice Address - Phone:928-442-0005
Practice Address - Fax:928-442-0660
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1608502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT160850Medicare ID - Type Unspecified