Provider Demographics
NPI:1841328887
Name:JEKANOWSKI, KATHERINE FRANCES (ATC,L CSCS)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:FRANCES
Last Name:JEKANOWSKI
Suffix:
Gender:F
Credentials:ATC,L CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3031
Mailing Address - Country:US
Mailing Address - Phone:413-542-5284
Mailing Address - Fax:413-542-8187
Practice Address - Street 1:266 S PLEASANT ST
Practice Address - Street 2:ALUMNI GYM BOX #2230
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-658-5074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer