Provider Demographics
NPI:1124500269
Name:STEPHANS, KAREN (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STEPHANS
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 1:15543 COUNTY 4
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55975-4745
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MN
Practice Address - Zip Code:55909-9764
Practice Address - Country:US
Practice Address - Phone:507-582-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist