Provider Demographics
NPI:1942622964
Name:KAREN ROAN'S PHYSICAL THERAPY AND REHABILITATION LLC
Entity Type:Organization
Organization Name:KAREN ROAN'S PHYSICAL THERAPY AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-339-1473
Mailing Address - Street 1:110 STONEBRIAR BLVD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8150
Mailing Address - Country:US
Mailing Address - Phone:561-339-1473
Mailing Address - Fax:
Practice Address - Street 1:1601 COMMERCE LN STE 104
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8818
Practice Address - Country:US
Practice Address - Phone:561-339-1473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy