Provider Demographics
NPI:1346569407
Name:DESPIEGELAERE, KARIN (PT)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:DESPIEGELAERE
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 1:126 COUNTRY CLUB DR W
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-4418
Mailing Address - Country:US
Mailing Address - Phone:850-362-6495
Mailing Address - Fax:
Practice Address - Street 1:2000 PRINIPAL LANE
Practice Address - Street 2:
Practice Address - City:FT. WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547
Practice Address - Country:US
Practice Address - Phone:850-362-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist