Provider Demographics
NPI:1518129725
Name:PAGE, KAREN M (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:PAGE
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 1:554 EAGLE MANOR LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2690
Mailing Address - Country:US
Mailing Address - Phone:314-542-0826
Mailing Address - Fax:314-542-0829
Practice Address - Street 1:554 EAGLE MANOR LN
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2690
Practice Address - Country:US
Practice Address - Phone:314-542-0826
Practice Address - Fax:314-542-0829
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01550225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist