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NPI Code Detail

MEDICARE: KARA BOBERA DPT

MEDICARE:   KARA  BOBERA  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist16002-24WI

General Provider Information

NPI Number : 1144952490
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARA BOBERA DPT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number : 586-350-2644
Fax Number :
Provider Business Practice Location Address
First Line : 11363 N PORT WASHINGTON RD
Second Line :
City : MEQUON
State : WI
Zip : 53092-3411
Country : US
Telephone Number : 262-833-2060
Fax Number : 262-833-2061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2022
Last Update Date : 05/27/2026

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