Provider Demographics
NPI:1013658541
Name:STEDHAM BARBER, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STEDHAM BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 GROUPER WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-2968
Mailing Address - Country:US
Mailing Address - Phone:912-409-2896
Mailing Address - Fax:
Practice Address - Street 1:107 GROUPER WAY
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-2968
Practice Address - Country:US
Practice Address - Phone:912-409-2896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist