Individual
MISS LISA ANN MCCARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6572
Mailing address
52 HOMESDALE AVE, SOUTHINGTON, CT 06489-3742
(860) 621-1576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002457
CT
363AM0700X
Medical Physician Assistant
Primary
002457
CT
Other
Enumeration date
09/27/2010
Last updated
11/21/2013
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