Provider Demographics
NPI:1114043007
Name:WYMAN, KAREN JP (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JP
Last Name:WYMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 CENTURY LN
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-8960
Mailing Address - Country:US
Mailing Address - Phone:610-459-3915
Mailing Address - Fax:
Practice Address - Street 1:1194 NAAMANS CREEK RD
Practice Address - Street 2:
Practice Address - City:BOOTHWYN
Practice Address - State:PA
Practice Address - Zip Code:19061-1615
Practice Address - Country:US
Practice Address - Phone:610-459-3160
Practice Address - Fax:610-459-3025
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000904E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist