Individual
ALF L CARROLL IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, WHITE 1, BOSTON, MA 02114-2621
(617) 724-4100
(617) 726-7415
Mailing address
55 FRUIT ST, WHITE 1, BOSTON, MA 02114-2621
(617) 724-4100
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA5935
MA
Other
Enumeration date
10/04/2016
Last updated
01/03/2017
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