Healthcare Provider Details

I. General information

NPI: 1467919548
Provider Name (Legal Business Name): KATARINA SOPHIA WEINBERG LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9548 PARK MEADOWS DR
LONE TREE CO
80124-5315
US

IV. Provider business mailing address

6734 SUMMER GRACE ST
COLORADO SPRINGS CO
80923-4442
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-2200
  • Fax: 720-553-0910
Mailing address:
  • Phone: 703-615-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: