Provider Demographics
NPI:1548382864
Name:BURT, KARLI MICHELLE (PT, DPT, ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:KARLI
Middle Name:MICHELLE
Last Name:BURT
Suffix:
Gender:F
Credentials:PT, DPT, ATC, LAT
Other - Prefix:MS
Other - First Name:KARLI
Other - Middle Name:MICHELLE
Other - Last Name:RULE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC, LAT
Mailing Address - Street 1:2310 GREENHILL RD
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455
Mailing Address - Country:US
Mailing Address - Phone:903-577-3700
Mailing Address - Fax:903-577-3701
Practice Address - Street 1:2310 GREENHILL RD
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455
Practice Address - Country:US
Practice Address - Phone:903-577-3700
Practice Address - Fax:903-577-3701
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172663225100000X
TX0305021482255A2300X
TXAT30772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer