Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 20688 | CA |
N | 2251S0007X | Physical Therapist - Sports | 5501014500 | MI |
Y | 2251X0800X | Physical Therapist - Orthopedic | 5501014500 | MI |
N | 2251X0800X | Physical Therapist - Orthopedic | PT20688 | CA |
NPI | 1235161050 |
---|---|
Provider Name | Ms. Karen Ellen Guerin |
First Address | Bloomfield Township, MI 48301 |
Second Address | San Diego, CA 92128-3709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 13/05/2010 |