Provider Demographics
NPI:1861161887
Name:SILVERTHORN, KATERI RYBICKI (DPT)
Entity type:Individual
Prefix:
First Name:KATERI
Middle Name:RYBICKI
Last Name:SILVERTHORN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 GRATIOT BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-2310
Mailing Address - Country:US
Mailing Address - Phone:810-201-4728
Mailing Address - Fax:810-821-8636
Practice Address - Street 1:1020 GRATIOT BLVD STE B
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-2310
Practice Address - Country:US
Practice Address - Phone:810-201-4728
Practice Address - Fax:810-821-8636
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501020257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist