Provider Demographics
NPI:1740369842
Name:ANGLIN, KAREN DENISE (PT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DENISE
Last Name:ANGLIN
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 1:421 ORCHARD VIEW CT
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-4338
Mailing Address - Country:US
Mailing Address - Phone:618-977-2918
Mailing Address - Fax:
Practice Address - Street 1:2920 FEE FEE RD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-1915
Practice Address - Country:US
Practice Address - Phone:314-291-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist