Provider Demographics
NPI:1497061857
Name:MINARCZIK, KARINA MARIE (PT)
Entity Type:Individual
Prefix:DR
First Name:KARINA
Middle Name:MARIE
Last Name:MINARCZIK
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 1:602 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2284
Mailing Address - Country:US
Mailing Address - Phone:440-670-9989
Mailing Address - Fax:440-398-0500
Practice Address - Street 1:602 TOURNAMENT DR
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2284
Practice Address - Country:US
Practice Address - Phone:440-670-9989
Practice Address - Fax:440-398-0500
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH128672251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics