Provider Demographics
NPI:1669512463
Name:ORT, KAREN LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:ORT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:3203 SUNSET HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-3024
Mailing Address - Country:US
Mailing Address - Phone:626-339-5595
Mailing Address - Fax:
Practice Address - Street 1:2125 WRIGHT AVE
Practice Address - Street 2:SUITE C1
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-5815
Practice Address - Country:US
Practice Address - Phone:909-392-3460
Practice Address - Fax:909-392-3140
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9174225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist