Healthcare Provider Details

I. General information

NPI: 1619421930
Provider Name (Legal Business Name): CATHERINE HOUSHOWER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COUNTRY CLUB RD
QUEENSBURY NY
12804-1702
US

IV. Provider business mailing address

201 SHELDON RD
DELANSON NY
12053-5816
US

V. Phone/Fax

Practice location:
  • Phone: 518-926-2075
  • Fax:
Mailing address:
  • Phone: 518-858-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: