Provider Demographics
NPI:1740315779
Name:ZOMCHEK, KAREN LYNN (DPT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:ZOMCHEK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 MAIN ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-4254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:493 MAIN ST
Practice Address - Street 2:SUITE 2F
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-4254
Practice Address - Country:US
Practice Address - Phone:978-449-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist