Provider Demographics
NPI:1295464642
Name:GORLEWSKI, KAREN NICOLE (PTA, ATC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:NICOLE
Last Name:GORLEWSKI
Suffix:
Gender:F
Credentials:PTA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 RIFLE LN
Mailing Address - Street 2:
Mailing Address - City:ELSMERE
Mailing Address - State:KY
Mailing Address - Zip Code:41018-2699
Mailing Address - Country:US
Mailing Address - Phone:859-802-7068
Mailing Address - Fax:
Practice Address - Street 1:68 CAVALIER BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1645
Practice Address - Country:US
Practice Address - Phone:859-283-0707
Practice Address - Fax:859-647-3022
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT4472255A2300X
KYA02978225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer