Provider Demographics
NPI:1497164883
Name:PLOTZ, KARYN (FPT)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:PLOTZ
Suffix:
Gender:F
Credentials:FPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 GRAND CENTRAL AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-1079
Mailing Address - Country:US
Mailing Address - Phone:304-693-2781
Mailing Address - Fax:
Practice Address - Street 1:1500 GRAND CENTRAL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-1079
Practice Address - Country:US
Practice Address - Phone:304-295-3060
Practice Address - Fax:304-295-3065
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT003301225100000X
OHPT.014594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist