Provider Demographics
NPI:1457591885
Name:ST.CLAIR, KARLENE MICHELLE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:KARLENE
Middle Name:MICHELLE
Last Name:ST.CLAIR
Suffix:
Gender:F
Credentials:MSPT
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Other - First Name:
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Mailing Address - Street 1:2233 ACADEMY PL
Mailing Address - Street 2:SUITE 50
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1696
Mailing Address - Country:US
Mailing Address - Phone:719-475-0808
Mailing Address - Fax:719-475-8822
Practice Address - Street 1:2955 PROFESSIONAL PL
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-8139
Practice Address - Country:US
Practice Address - Phone:719-227-7079
Practice Address - Fax:719-227-7061
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2011-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNPT4892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA104742Medicare PIN