Provider Demographics
NPI:1396833802
Name:DURDEN, KAREN BROWN (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:BROWN
Last Name:DURDEN
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 1:399 BAKERS FERRY TRL
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4956
Mailing Address - Country:US
Mailing Address - Phone:706-650-9397
Mailing Address - Fax:
Practice Address - Street 1:350 AUSTIN GRAYBILL RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-9251
Practice Address - Country:US
Practice Address - Phone:803-278-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1217225100000X
GAPT002430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist