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General NPI Number Information
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NPI Number | 1255658795
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Entity Type | Individual
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Provider Name | KAREN CROFTS TYSON LMT
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Gender | Female
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 1315 HERR LN SUITE 201
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City | LOUISVILLE
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State | KY
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Zip | 40222-4376
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Country | US
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Telephone | 502-426-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 REMS CT
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City | LOUISVILLE
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State | KY
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Zip | 40241-2525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | KY-0941
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License Number State | KY
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