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General NPI Number Information
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NPI Number | 1326162249
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Entity Type | Individual
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Provider Name | KAREN SUE STORK RN, LMT, CLT
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Gender | Female
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Dates
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Enumeration Date | 03/17/2007
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 693 READING AVE
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City | WEST READING
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State | PA
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Zip | 19611-1009
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Country | US
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Telephone | 610-736-0800
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Fax | 610-736-0456
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Provider Business Mailing Address
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Address Line | 693 READING AVE
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City | WEST READING
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State | PA
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Zip | 19611-1009
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Country | US
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Telephone | 610-736-0800
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Fax | 610-736-0456
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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 | MSG001255
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN503089L
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License Number State | PA
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