Individual
MINDI RAY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3002 AVENUE Q, HONDO, TX 78861-3422
(830) 426-3056
Mailing address
PO BOX 212, LYTLE, TX 78052-0212
(210) 844-1906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2097212
TX
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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