Provider Demographics
NPI:1265600167
Name:POWRIE, KARLA SUE (PT)
Entity type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:SUE
Last Name:POWRIE
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 1:3101 STONINGTON CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-2933
Mailing Address - Country:US
Mailing Address - Phone:502-339-9860
Mailing Address - Fax:
Practice Address - Street 1:1410 LONG RUN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-4334
Practice Address - Country:US
Practice Address - Phone:502-244-8011
Practice Address - Fax:502-244-6631
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100298470Medicaid
KY000000865958OtherANTHEM
KY7100298470Medicaid