Individual
TRICIA MARIE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6199
(706) 272-6291
Mailing address
87 CATTAIL DR, ROCK SPRING, GA 30739-4082
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002331
GA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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