Provider Demographics
NPI:1376001735
Name:EDER, KAREN LESLIE (ATC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LESLIE
Last Name:EDER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 UPPER CHESAPEAKE DR STE 417
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4336
Mailing Address - Country:US
Mailing Address - Phone:443-643-3130
Mailing Address - Fax:443-643-3133
Practice Address - Street 1:510 UPPER CHESAPEAKE DR STE 417
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4336
Practice Address - Country:US
Practice Address - Phone:443-643-3130
Practice Address - Fax:443-643-3133
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00001072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty