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General NPI Number Information
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NPI Number | 1730302274
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Entity Type | Individual
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Provider Name | KATHRYN THERESA GOLLOTTO DO
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 165 HIGHWAY 50
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City | STATELINE
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State | NV
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Zip | 89449-9816
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Country | US
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Telephone | 775-589-8915
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Fax | 530-999-4311
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Provider Business Mailing Address
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Address Line | 2170 SOUTH AVE
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7026
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Country | US
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Telephone | 530-541-3420
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Fax |
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 25MB08571200
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OT011173
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License Number State | NV
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