Individual
BENJAMIN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3101 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092-6690
(817) 251-6351
Mailing address
3101 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092-6690
(817) 251-6351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1258357
TX
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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