Provider Demographics
NPI:1730235029
Name:CHEVALIER, CATHERINE KOENIG
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KOENIG
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:SUSAN
Other - Last Name:KOENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5026 HIGHLAND 17.6 DR
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-9443
Mailing Address - Country:US
Mailing Address - Phone:906-399-8585
Mailing Address - Fax:
Practice Address - Street 1:901 S LINCOLN RD STE B
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-2150
Practice Address - Country:US
Practice Address - Phone:906-789-1011
Practice Address - Fax:906-789-1500
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005222225100000X
WA2865225100000X
TX1180810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist