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Individual

MR. JAMISON KEITH CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
447328
OR
225X00000X
Occupational Therapist
OTH-008360
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568052595
OR
Enumeration date
01/23/2021
Last updated
02/21/2023
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If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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