Healthcare Provider Details

I. General information

NPI: 1538270103
Provider Name (Legal Business Name): KAREN A ZYLSTRA PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 AMERICAN WAY CT HEARTLAND REHABILITATION SERVICES
BEDFORD VA
24523
US

IV. Provider business mailing address

1364 AMERICAN WAY CT HEARTLAND REHABILITATION SERVICES
BEDFORD VA
24523
US

V. Phone/Fax

Practice location:
  • Phone: 540-587-5582
  • Fax: 540-587-0249
Mailing address:
  • Phone: 540-587-5582
  • Fax: 540-587-0249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305005053
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: