Provider Demographics
NPI:1518411859
Name:SMITH, KAREN LUBECK (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LUBECK
Last Name:SMITH
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 1:509 N ELAM AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1157
Mailing Address - Country:US
Mailing Address - Phone:362-741-1143
Mailing Address - Fax:336-274-9638
Practice Address - Street 1:509 N ELAM AVE FL 2
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403
Practice Address - Country:US
Practice Address - Phone:336-274-1114
Practice Address - Fax:336-274-9638
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist