Healthcare Provider Details

I. General information

NPI: 1073648655
Provider Name (Legal Business Name): KAREN VIRGINIA ZIRKLE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

IV. Provider business mailing address

1013 WALNUT AVE
REDLANDS CA
92373-6635
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-5617
  • Fax: 909-335-6481
Mailing address:
  • Phone: 909-792-1737
  • Fax: 909-335-6481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15532
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: