Individual
ANDREW CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-8707
Mailing address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-8707
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
225100000X
Physical Therapist
Primary
1298447
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1298447
STATE LICENSE
TX
Enumeration date
09/05/2017
Last updated
02/05/2026
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