Provider Demographics
NPI:1598917304
Name:FLANAGAN, KAREN U (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:U
Last Name:FLANAGAN
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 1:1560 HENTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1371
Mailing Address - Country:US
Mailing Address - Phone:419-866-5196
Mailing Address - Fax:419-866-5663
Practice Address - Street 1:113 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH BALTIMORE
Practice Address - State:OH
Practice Address - Zip Code:45872-1124
Practice Address - Country:US
Practice Address - Phone:419-257-9070
Practice Address - Fax:419-257-0501
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT003592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1609899061OtherCORPORATE NPI
OH0392980Medicaid
OH2526654Medicaid