Provider Demographics
NPI:1679843114
Name:VANDERHEI, KARI SUZANNE (PT)
Entity Type:Individual
Prefix:MISS
First Name:KARI
Middle Name:SUZANNE
Last Name:VANDERHEI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KARI
Other - Middle Name:SUZANNE
Other - Last Name:MCKINNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:18246 W EAST WIND AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5062
Mailing Address - Country:US
Mailing Address - Phone:623-203-0844
Mailing Address - Fax:
Practice Address - Street 1:18246 W EAST WIND AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-5062
Practice Address - Country:US
Practice Address - Phone:623-203-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist