Provider Demographics
NPI:1043531510
Name:OSTERHAUS, KATIE KRISTINE (PT, LAT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:KRISTINE
Last Name:OSTERHAUS
Suffix:
Gender:F
Credentials:PT, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9452 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813-9746
Mailing Address - Country:US
Mailing Address - Phone:608-723-3236
Mailing Address - Fax:608-723-3379
Practice Address - Street 1:615 ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:FENNIMORE
Practice Address - State:WI
Practice Address - Zip Code:53809-1130
Practice Address - Country:US
Practice Address - Phone:563-583-4003
Practice Address - Fax:563-265-5789
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11248-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist