Provider Demographics
NPI:1912193228
Name:DYS, KAREN RENAE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:RENAE
Last Name:DYS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RENAE
Other - Last Name:PEHRSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44 E 8TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3575
Mailing Address - Country:US
Mailing Address - Phone:616-392-3197
Mailing Address - Fax:
Practice Address - Street 1:3491 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MI
Practice Address - Zip Code:49419-9512
Practice Address - Country:US
Practice Address - Phone:269-751-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant