Provider Demographics
NPI:1912369844
Name:LIPPO, KARI (PT)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:
Last Name:LIPPO
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 1:13679 145TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORESTON
Mailing Address - State:MN
Mailing Address - Zip Code:56330-9564
Mailing Address - Country:US
Mailing Address - Phone:952-270-4840
Mailing Address - Fax:
Practice Address - Street 1:253 PINE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:MN
Practice Address - Zip Code:56329-9000
Practice Address - Country:US
Practice Address - Phone:320-968-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN69642251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics