MEDICARE: MS. CATHARINE NICOLE KELLER PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	60737922	WA

General Provider Information

NPI Number	:	1184150906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHARINE NICOLE KELLER PT, DPT

Provider Business Mailing Address
First Line	:	599 FIVE CARD DRAW
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-0811
Country	:	US
Telephone Number	:	541-645-4512
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 CLAREMONT ST
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-3551
Country	:	US
Telephone Number	:	406-752-9692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	04/07/2025

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