Individual
ANDRE B CARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
463 TREMONT ST W STE 100, PORT ORCHARD, WA 98366
(360) 874-0745
(360) 874-0846
Mailing address
463 TREMONT ST W STE 100, PORT ORCHARD, WA 98366-3743
(360) 874-0745
(360) 874-0846
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60780941
WA
2251X0800X
Orthopedic Physical Therapist
PT19433
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00640460
RAILROAD MEDICARE
FL
Enumeration date
10/17/2005
Last updated
06/05/2018
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