Karolee Stauduhar, PT

Individual provider Active NPI Physical Therapist · Clermont, GA

NPI 1578733754 · NPPES record last updated Aug 19, 2024

Key facts

NPI
1578733754
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT010466 (GA)
Practice address
130 Main St
Clermont, GA 30527-1804
Phone
(678) 616-3099
Fax
(770) 406-6840
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT 6592FLMDPhysical Therapist
PT010466GAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 6592 FL
Physical Therapist 225100000X PT010466 GA Yes

Addresses

Primary practice location

130 Main St
Clermont, GA 30527-1804

Mailing address

598 River Forest Run
Cleveland, GA 30528-3181
Phone (407) 718-7531

Other practice location 1

598 River Forest Run
Cleveland, GA 30528-3181
Phone (407) 718-7531

Other providers in Clermont, GA

All providers in Clermont, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.