Provider Demographics
NPI:1649218066
Name:MAINZER, KAREN (OTR L CHT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MAINZER
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13537 BARRETT PARKWAY DRIVE
Mailing Address - Street 2:STE 105 PRO REHAB
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021
Mailing Address - Country:US
Mailing Address - Phone:314-821-9126
Mailing Address - Fax:314-821-9142
Practice Address - Street 1:12468 ST CHARLES ROCK ROAD
Practice Address - Street 2:PRO REHAB
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-739-1123
Practice Address - Fax:314-739-1173
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004000205225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand