Provider Demographics
NPI:1376934331
Name:RAUSS, KAREN (ATCL)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:RAUSS
Suffix:
Gender:F
Credentials:ATCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7219 DAERWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-9071
Mailing Address - Country:US
Mailing Address - Phone:704-651-9187
Mailing Address - Fax:
Practice Address - Street 1:6050 HICKORY GROVE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4130
Practice Address - Country:US
Practice Address - Phone:704-531-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer