Provider Demographics
NPI:1518085182
Name:MCPHERSON, KAREN LEE (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:WNOROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:26025 LAHSER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2601
Mailing Address - Country:US
Mailing Address - Phone:248-663-1906
Mailing Address - Fax:248-631-1903
Practice Address - Street 1:26025 LAHSER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2601
Practice Address - Country:US
Practice Address - Phone:248-663-1906
Practice Address - Fax:248-631-1903
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501003534OtherPHYSICAL THERAPY LIC. NUM
MIM08420020Medicare ID - Type Unspecified