Provider Demographics
NPI:1184182933
Name:LINDROTH-YATES, KARLY ANNE
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:ANNE
Last Name:LINDROTH-YATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 OWENS ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-4938
Mailing Address - Country:US
Mailing Address - Phone:256-543-1030
Mailing Address - Fax:256-439-2830
Practice Address - Street 1:1235 YANCEY ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:AL
Practice Address - Zip Code:36274-2141
Practice Address - Country:US
Practice Address - Phone:334-863-3535
Practice Address - Fax:334-863-7276
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH9316OtherPHYSICAL THERAPY