MEDICARE: KATELYN FAIR 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

General Provider Information

NPI Number	:	1437088978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN FAIR DPT

Provider Business Mailing Address
First Line	:	4424 N SAGINAW RD
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48640-2370
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4424 N SAGINAW RD
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48640-2370
Country	:	US
Telephone Number	:	989-495-2255
Fax Number	:

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

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “ KATELYN FAIR DPT” Practice Location

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