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Individual
THERESA A CARROLL
Active
Individual
THERESA A CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305206103
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679704951
—
VA
01
—
9409378
AETNA
VA
01
—
P00748138
RAILROAD MEDICARE
VA
Enumeration date
08/04/2009
Last updated
10/27/2009
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