Provider Demographics
NPI:1194918581
Name:DREFS, KARA SUSAN (MSPT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:SUSAN
Last Name:DREFS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:SUSAN
Other - Last Name:SEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:BLUE 3
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-4330
Mailing Address - Fax:
Practice Address - Street 1:2800 E HIGHWAY 114 STE 120
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5305
Practice Address - Country:US
Practice Address - Phone:817-491-3403
Practice Address - Fax:817-491-3308
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6307225100000X
TX1284528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist