Provider Demographics
NPI:1376634402
Name:BAIR, KAREN J (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:BAIR
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 1:6375 MERCURY DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-591-3000
Mailing Address - Fax:717-591-3003
Practice Address - Street 1:6375 MERCURY DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-591-3000
Practice Address - Fax:717-591-3003
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005304L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0078126060002Medicaid
PA100800QZ0Medicare ID - Type UnspecifiedGROUP