Provider Demographics
NPI:1548357494
Name:BLOCK, KAREN IRENE (CRT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:IRENE
Last Name:BLOCK
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
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Mailing Address - Street 1:W51 N214 FILLMORE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012
Mailing Address - Country:US
Mailing Address - Phone:262-375-0710
Mailing Address - Fax:
Practice Address - Street 1:11649 N PORT WASHINGTON RD
Practice Address - Street 2:#109
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092
Practice Address - Country:US
Practice Address - Phone:262-241-8022
Practice Address - Fax:267-241-8047
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1539 0282279S1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredSNF/Subacute Care