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General NPI Number Information
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NPI Number | 1235296849
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Entity Type | Individual
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Provider Name | CATHLEEN MARIE GEPHART PT, OCS
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 2005 IRONWOOD PKWY STE 224
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2647
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Country | US
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Telephone | 208-661-7167
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Fax | 208-665-2468
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Provider Business Mailing Address
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Address Line | 2005 IRONWOOD PKWY STE 224
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2647
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Country | US
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Telephone | 208-665-2468
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Fax | 208-665-2468
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT-798
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT00005952
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License Number State | WA
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