Provider Demographics
NPI:1407467020
Name:GAYDOS, KARLIE (DPT)
Entity Type:Individual
Prefix:
First Name:KARLIE
Middle Name:
Last Name:GAYDOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24303 GRAVEL RUN RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16403-6005
Mailing Address - Country:US
Mailing Address - Phone:814-573-1475
Mailing Address - Fax:
Practice Address - Street 1:9108 PA-198
Practice Address - Street 2:
Practice Address - City:CONNEAUTVILLE
Practice Address - State:PA
Practice Address - Zip Code:16406
Practice Address - Country:US
Practice Address - Phone:814-587-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018603225100000X
PAPT028542225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist