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Individual

CAROLYN FARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
571 MERIT ST, CLEWISTON, FL 33440-5482
(754) 317-2061
Mailing address
515 W HAITI AVE, CLEWISTON, FL 33440-4316
(754) 317-2061

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
236484
FL
376J00000X
Homemaker

Other

Enumeration date
12/05/2019
Last updated
05/05/2020
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