Provider Demographics
NPI:1679697833
Name:CHEVALIER, KAREN (MSPT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 DAY HILL RD
Mailing Address - Street 2:UNIT 10
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1795
Mailing Address - Country:US
Mailing Address - Phone:860-687-0765
Mailing Address - Fax:860-687-0795
Practice Address - Street 1:555 DAY HILL RD
Practice Address - Street 2:UNIT 10
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1795
Practice Address - Country:US
Practice Address - Phone:860-687-0765
Practice Address - Fax:860-687-0795
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist