Provider Demographics
NPI:1346580016
Name:BECHTOLD, KAREN LEE (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:BECHTOLD
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 1:6553 GULF GATE PL APT 248
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5848
Mailing Address - Country:US
Mailing Address - Phone:828-273-7523
Mailing Address - Fax:
Practice Address - Street 1:6553 GULF GATE PL APT 248
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:828-273-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31933225100000X
VA2305205230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist