Provider Demographics
NPI:1881277614
Name:MCCORMICK, KAREN M (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:MCCORMICK
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 1:3 PARTRIDGE PATH
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1515
Mailing Address - Country:US
Mailing Address - Phone:774-368-0415
Mailing Address - Fax:
Practice Address - Street 1:290 TURNPIKE RD STE 5-326
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2843
Practice Address - Country:US
Practice Address - Phone:631-278-0665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist