Provider Demographics
NPI:1689630360
Name:CONNOR, KAREN L (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:CONNOR
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 1:137 WINCKLES STREET
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-366-5993
Mailing Address - Fax:440-366-5313
Practice Address - Street 1:137 WINCKLES STREET
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035
Practice Address - Country:US
Practice Address - Phone:440-366-5993
Practice Address - Fax:440-366-5313
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341490517044OtherCARESOURCE
000000359891OtherANTHEM BCBS
OH654140OtherAETNA