Provider Demographics
NPI:1144427535
Name:CULLER, KAREN LYNETTE (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNETTE
Last Name:CULLER
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 1:6011 FOREST BRK
Mailing Address - Street 2:
Mailing Address - City:LANESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47136-9402
Mailing Address - Country:US
Mailing Address - Phone:812-952-1918
Mailing Address - Fax:
Practice Address - Street 1:517 N HALLMARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-6629
Practice Address - Country:US
Practice Address - Phone:812-282-4506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009145A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist