Provider Demographics
NPI:1699063859
Name:FORD, KAREN E (DPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:FORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:E
Other - Last Name:SERAFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 PARK ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3311
Mailing Address - Country:US
Mailing Address - Phone:413-785-1153
Mailing Address - Fax:413-781-4951
Practice Address - Street 1:271 PARK ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3311
Practice Address - Country:US
Practice Address - Phone:413-785-1153
Practice Address - Fax:413-732-3623
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist