Provider Demographics
NPI:1073710042
Name:MCBRIDE, KARI LYNN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:LYNN
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 JEFFRIES LN
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-3053
Mailing Address - Country:US
Mailing Address - Phone:812-490-6691
Mailing Address - Fax:
Practice Address - Street 1:509 N CARRIER ST
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-1201
Practice Address - Country:US
Practice Address - Phone:270-389-3513
Practice Address - Fax:270-389-4706
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAOO834225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant