Individual
MR. JAMES LEO CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
339 TANGIERS, JEFFERSON, TX 75657-0598
(903) 665-7055
Mailing address
PO BOX 598, JEFFERSON, TX 75657-0598
(903) 665-7055
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2017901
TX
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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