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General NPI Number Information
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NPI Number | 1700109782
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Entity Type | Individual
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Provider Name | KARLA J CARR OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 200 STAHLHUT DR
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City | LINCOLN
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State | IL
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Zip | 62656-5066
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Country | US
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Telephone | 217-605-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 311 N DICKEY ST
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City | DELAVAN
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State | IL
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Zip | 61734-9281
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Country | US
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Telephone | 309-244-8608
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056002458
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License Number State | IL
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