Basic Information
| Provider Information | |||||||||
| NPI: | 1548454028 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEDENSCHOUG | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT, OCS, CSCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PSC 80 BOX 17473 | ||||||||
| Address2: | |||||||||
| City: | APO | ||||||||
| State: | AP | ||||||||
| PostalCode: | 963670077 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 18TH MEDICAL GROUP | ||||||||
| Address2: | UNIT 5142 | ||||||||
| City: | APO | ||||||||
| State: | AP | ||||||||
| PostalCode: | 963685142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9999999999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2007 | ||||||||
| LastUpdateDate: | 07/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 34569 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.