Healthcare Provider Details

I. General information

NPI: 1073889713
Provider Name (Legal Business Name): KATHERINE ELIZABETH LINDEMUTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE ELIZABETH ADLER

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 02/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 0LD COUNTY RD
TRURO MA
02666
US

IV. Provider business mailing address

PO BOX 544 139 OLD COUNTY RD
TRURO MA
02666-0544
US

V. Phone/Fax

Practice location:
  • Phone: 760-580-2483
  • Fax:
Mailing address:
  • Phone: 760-580-2483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14295
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number251958
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10310
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: