Individual
CLARISSA CARNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
260 SUNRISE BLVD, ROMNEY, WV 26757-6345
(304) 822-7527
Mailing address
10790 FORT ASHBY RD, KEYSER, WV 26726-6229
(304) 813-6597
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002760
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002760
PHYSICAL THERAPIST ASSISTANT
WV
Enumeration date
09/08/2021
Last updated
09/08/2021
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