Individual
TIMOTHY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7540 N 19TH AVE, PHOENIX, AZ 85021-7967
(888) 873-4221
Mailing address
7540 N 19TH AVE, PHOENIX, AZ 85021-7967
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0014442
CO
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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