Provider Demographics
NPI:1326777186
Name:GALLARDO, KAREN ANNE ALMEDA (DPT)
Entity Type:Individual
Prefix:
First Name:KAREN ANNE
Middle Name:ALMEDA
Last Name:GALLARDO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6683
Mailing Address - Country:US
Mailing Address - Phone:734-846-0836
Mailing Address - Fax:
Practice Address - Street 1:3339 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-5454
Practice Address - Country:US
Practice Address - Phone:248-918-4966
Practice Address - Fax:248-918-4948
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501021520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist