MEDICARE: KATELYN IRENE FLECK PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05014672A	IN

General Provider Information

NPI Number	:	1114645314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN IRENE FLECK PT, DPT

Provider Business Mailing Address
First Line	:	7071 MORELLO LN
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46062-8431
Country	:	US
Telephone Number	:	812-630-6019
Fax Number	:

Provider Business Practice Location Address
First Line	:	14701 CUMBERLAND RD STE 300
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4374
Country	:	US
Telephone Number	:	317-284-1166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	05/31/2026

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