Provider Demographics
NPI:1861227563
Name:KATE FETHER PHYSIO & DANCE LLC
Entity type:Organization
Organization Name:KATE FETHER PHYSIO & DANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FETHER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-840-9404
Mailing Address - Street 1:1708 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-1516
Mailing Address - Country:US
Mailing Address - Phone:248-840-9404
Mailing Address - Fax:
Practice Address - Street 1:6044 US 41 S STE 1
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9090
Practice Address - Country:US
Practice Address - Phone:248-840-9404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty