Provider Demographics
NPI:1134132491
Name:JOHANNES, KAREN (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JOHANNES
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 1:6613 W 69TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-3613
Mailing Address - Country:US
Mailing Address - Phone:303-456-8967
Mailing Address - Fax:303-456-8972
Practice Address - Street 1:7878 WADSWORTH BLVD
Practice Address - Street 2:STE 210
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2146
Practice Address - Country:US
Practice Address - Phone:303-456-8967
Practice Address - Fax:303-456-8972
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist