Provider Demographics
NPI:1427392828
Name:RUPRECHT, KARL JOSEF (PT)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:JOSEF
Last Name:RUPRECHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 LYNWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4134
Mailing Address - Country:US
Mailing Address - Phone:208-736-8648
Mailing Address - Fax:
Practice Address - Street 1:649 LYNWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4134
Practice Address - Country:US
Practice Address - Phone:208-736-8648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-15312251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics