Provider Demographics
NPI:1841954674
Name:TRIMMER, KAREN ALICIA (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ALICIA
Last Name:TRIMMER
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 1:1416 W BRAKER LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3702
Mailing Address - Country:US
Mailing Address - Phone:915-309-0165
Mailing Address - Fax:
Practice Address - Street 1:1416 W BRAKER LN UNIT B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3702
Practice Address - Country:US
Practice Address - Phone:915-309-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1309767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist