MEDICARE: KARLA FUHLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	160-002201	IL

General Provider Information

NPI Number	:	1396038659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA FUHLER

Provider Business Mailing Address
First Line	:	691 WAYNE ST
Second Line	:
City	:	CARLYLE
State	:	IL
Zip	:	62231-6801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	691 WAYNE ST
Second Line	:
City	:	CARLYLE
State	:	IL
Zip	:	62231-6801
Country	:	US
Telephone Number	:	618-541-1895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	05/19/2011

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Directions to “ KARLA FUHLER ” Practice Location

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