Provider Demographics
NPI:1538147475
Name:FREI, KATHERINE MARIE (PT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:FREI
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 1:2411 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5779
Mailing Address - Country:US
Mailing Address - Phone:702-458-1300
Mailing Address - Fax:702-548-1300
Practice Address - Street 1:2411 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5779
Practice Address - Country:US
Practice Address - Phone:702-458-1300
Practice Address - Fax:702-548-1300
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-31
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVRPT325Medicare ID - Type Unspecified