Provider Demographics
NPI:1053492074
Name:VONDERHAAR, KAREN S (MS, PT, OCS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:VONDERHAAR
Suffix:
Gender:F
Credentials:MS, PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270217
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-5003
Mailing Address - Country:US
Mailing Address - Phone:303-446-2200
Mailing Address - Fax:303-446-2201
Practice Address - Street 1:11025 N. DOVER ST
Practice Address - Street 2:SUITE 400
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021
Practice Address - Country:US
Practice Address - Phone:303-446-2200
Practice Address - Fax:303-446-2201
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IMS67413OtherBCBS
A002OtherTRICARE
IMS67413OtherBCBS