Healthcare Provider Details

I. General information

NPI: 1952682700
Provider Name (Legal Business Name): I KAREN HOWARD MS, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 CIRCLE HILL DR
SELMER TN
38375-2292
US

IV. Provider business mailing address

PO BOX 54
ADAMSVILLE TN
38310-0054
US

V. Phone/Fax

Practice location:
  • Phone: 850-238-9382
  • Fax:
Mailing address:
  • Phone: 850-238-9382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT9495
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT21414
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: