Provider Demographics
NPI:1952840266
Name:KANE, KATHERINE MCLELLAND (PT, DPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCLELLAND
Last Name:KANE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:MCLELLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1840 FRENCH SANTEE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29453-3138
Mailing Address - Country:US
Mailing Address - Phone:850-380-0590
Mailing Address - Fax:
Practice Address - Street 1:3001 S CREASY LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5206
Practice Address - Country:US
Practice Address - Phone:765-474-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL46332255A2300X
IN05013994A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer