Provider Demographics
NPI:1104831585
Name:LAROCCA, KAREN B (PT, MS, DPT)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:B
Last Name:LAROCCA
Suffix:
Gender:F
Credentials:PT, MS, DPT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:B
Other - Last Name:MONSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,MS,DPT
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:434-845-9053
Mailing Address - Fax:434-516-5960
Practice Address - Street 1:20311 TIMBERLAKE RD STE B
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7203
Practice Address - Country:US
Practice Address - Phone:434-237-6812
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011244-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ79441Medicare ID - Type Unspecified