Individual
CLAYTON O CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, SCS
Contact information
Practice address
6422 BELLS FERRY RD UNIT B124, WOODSTOCK, GA 30189-6114
(770) 372-1211
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013679
GA
Other
Enumeration date
07/27/2018
Last updated
06/10/2024
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