Provider Demographics
NPI:1801269824
Name:SHEETZ, KARLA (PTA)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:SHEETZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23232 245TH ST
Mailing Address - Street 2:
Mailing Address - City:KEOSAUQUA
Mailing Address - State:IA
Mailing Address - Zip Code:52565-8037
Mailing Address - Country:US
Mailing Address - Phone:319-293-6231
Mailing Address - Fax:
Practice Address - Street 1:23232 245TH ST
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-8037
Practice Address - Country:US
Practice Address - Phone:319-293-6231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001189225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA001189OtherSTATE OF IOWA, PHYSICAL THERAPY LICENSING BOARD