Provider Demographics
NPI:1366881765
Name:DEWANE, KAREN L (PT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:DEWANE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RED FOX LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2129
Mailing Address - Country:US
Mailing Address - Phone:610-935-1391
Mailing Address - Fax:
Practice Address - Street 1:456 SAINT DAVIDS AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4203
Practice Address - Country:US
Practice Address - Phone:610-225-2451
Practice Address - Fax:610-964-6166
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist