Provider Demographics
NPI:1487659645
Name:WELLS, KAREN K (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:K
Last Name:WELLS
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 1:328 THOMAS MORE PKWY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3488
Mailing Address - Country:US
Mailing Address - Phone:513-347-9999
Mailing Address - Fax:859-344-4153
Practice Address - Street 1:328 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3488
Practice Address - Country:US
Practice Address - Phone:513-347-9999
Practice Address - Fax:859-344-4153
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT069012251X0800X
KYPT0026332251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2526369Medicaid
KY87001533Medicaid
OH2526369Medicaid
KY0239483Medicare PIN
P52088Medicare UPIN
OHWE4069774Medicare PIN