Provider Demographics
NPI:1366863912
Name:LYLES, KAREN GEORGE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:GEORGE
Last Name:LYLES
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 1:256 HARRIET LN
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4617
Mailing Address - Country:US
Mailing Address - Phone:401-617-2287
Mailing Address - Fax:401-333-8937
Practice Address - Street 1:256 HARRIET LN
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4617
Practice Address - Country:US
Practice Address - Phone:401-617-2287
Practice Address - Fax:401-333-8937
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-29
Last Update Date:2013-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI8552251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics