Provider Demographics
NPI:1730206632
Name:FELTS, KATHLEEN BRINKMAN (PT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:BRINKMAN
Last Name:FELTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:FELTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:4010 69TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-5916
Mailing Address - Country:US
Mailing Address - Phone:806-796-0319
Mailing Address - Fax:
Practice Address - Street 1:3710 4TH STREET
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415
Practice Address - Country:US
Practice Address - Phone:806-763-4455
Practice Address - Fax:806-763-4435
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist