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Individual

KAREN SHRADER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
320 BOWSER AVE, CHESTERTON, IN 46304-2504
(219) 929-1740
Mailing address
320 BOWSER AVE, CHESTERTON, IN 46304-2504

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
06004311A
IN
174400000X
Specialist
160005847
IL

Other

Enumeration date
03/02/2013
Last updated
03/02/2013
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