Provider Demographics
NPI:1518782705
Name:ADJUTANT, KATIE B (LMT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:B
Last Name:ADJUTANT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:MELVIN VILLAGE
Mailing Address - State:NH
Mailing Address - Zip Code:03850-0242
Mailing Address - Country:US
Mailing Address - Phone:603-515-6830
Mailing Address - Fax:
Practice Address - Street 1:5 ELM ST
Practice Address - Street 2:UNIT 3
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894
Practice Address - Country:US
Practice Address - Phone:603-515-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6026172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist