Individual
MR. ROBERT JOSEPH CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
146 WATER ST, SALEM, WV 26426-1154
(304) 782-3000
Mailing address
146 WATER ST, SALEM, WV 26426-1154
(304) 782-3000
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
PT 001167
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 001167
PHYSICAL THERAPIST LICENSE
WV
Enumeration date
11/22/2012
Last updated
11/22/2012
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