| KT Therapy LLC | |
|
109 E Clinton St Ste 10 Goshen IN 46528-3233 | |
| (215) 280-2118 | |
| Not Available |
| Full Name | KT Therapy LLC |
|---|---|
| Speciality | Social Worker |
| Location | 109 E Clinton St Ste 10, Goshen, Indiana |
| Authorized Official Name and Position | Karla Thut (MANAGER) |
| Authorized Official Contact | 2152802118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| KT Therapy LLC 109 E Clinton St Ste 10 Goshen IN 46528-3233 | KT Therapy LLC 109 E Clinton St Ste 10 Goshen IN 46528-3233 Ph: (215) 280-2118 |
| NPI Number | 1285449769 |
|---|---|
| Provider Enumeration Date | 02/11/2025 |
| Last Update Date | 02/11/2025 |
| Certification Date | 02/11/2025 |
| Medicare PECOS PAC ID | 9335662063 |
|---|---|
| Medicare Enrollment ID | O20250402003230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285449769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
| Provider Name | Karla Patricia Thut |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720741184 PECOS PAC ID: 0244753978 Enrollment ID: I20250402003266 |
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