Individual
ALICE CARBALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
709 E NORTH PL, AMITE, LA 70422-2307
(985) 748-9464
Mailing address
19469 PAR LN, HAMMOND, LA 70401-8242
(504) 458-8896
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05230
LA
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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