Provider Demographics
NPI:1619093945
Name:JUDGE, KARLA SUE (ATC)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:SUE
Last Name:JUDGE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 ROCKRIDGE CT APT 1
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-9048
Mailing Address - Country:US
Mailing Address - Phone:406-531-2561
Mailing Address - Fax:
Practice Address - Street 1:RHINEHART ATC
Practice Address - Street 2:32 CAMPUS DRIVE
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59812-0001
Practice Address - Country:US
Practice Address - Phone:406-243-6362
Practice Address - Fax:406-243-5981
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer