Individual
BURL EDWIN CARROLL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1414 MAIN ST STE 3A, CHIPLEY, FL 32428-6951
(850) 638-3387
Mailing address
PO BOX 1113, CARYVILLE, FL 32425-1113
(850) 547-2030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5589
FL
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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