Provider Demographics
NPI:1962972869
Name:SCHADE, KATLIN
Entity type:Individual
Prefix:
First Name:KATLIN
Middle Name:
Last Name:SCHADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 COULEE DR
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6874
Mailing Address - Country:US
Mailing Address - Phone:608-792-5658
Mailing Address - Fax:
Practice Address - Street 1:N5445 CIRCLE DR E
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-9203
Practice Address - Country:US
Practice Address - Phone:608-792-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer