Provider Demographics
NPI:1558518092
Name:COWAN, KAREN SUE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:COWAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2210 LELARAY ST
Mailing Address - Street 2:DEVELOPMENTAL PEDIATRICS INC
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909
Mailing Address - Country:US
Mailing Address - Phone:719-475-0477
Mailing Address - Fax:719-475-1021
Practice Address - Street 1:2210 LELARAY ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909
Practice Address - Country:US
Practice Address - Phone:719-475-0477
Practice Address - Fax:719-475-1021
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3309225100000X
CAPT13086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist