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NPI Code Detail

MEDICARE: MRS. KAREN DENISE ANGLIN PT

MEDICARE: MRS. KAREN DENISE ANGLIN PT
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 Therapist2002010566MO

General Provider Information

NPI Number : 1740369842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN DENISE ANGLIN PT
Provider Business Mailing Address
First Line : 421 ORCHARD VIEW CT
Second Line :
City : GLEN CARBON
State : IL
Zip : 62034-4338
Country : US
Telephone Number : 618-977-2918
Fax Number :
Provider Business Practice Location Address
First Line : 2920 FEE FEE RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-1915
Country : US
Telephone Number : 314-291-0121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 07/15/2015

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